肿瘤细胞诱导的血小板聚集在肿瘤转移中的作用及鸡血藤治疗的应用展望

肿瘤转移是肿瘤患者的首要死因。抗转移治疗药物匮乏是肿瘤治疗的瓶颈问题。研究表明,肿瘤细胞诱导的血小板聚集(TCIPA)是肿瘤-血小板相互作用的基础,其密切调节着肿瘤血行转移的各个进程,具有平衡双向调控的特色:一方面,肿瘤能够诱导血小板向其聚集从而保护肿瘤细胞的生存以及免疫逃逸;另一方面,激活的血小板反向促进着肿瘤细胞的血行运输及远隔转移灶的形成等过程。鸡血藤为一味经典的活血化瘀中药,多部中医药古籍中都记载了其具有显著的"去瘀血、生新血"等作用,且该药物大多作用于血液,以改善血凝状态为特征。近年来,有更多的报道研究发现其可通过调节血液微环境,发挥抗肿瘤转移的药效作用。在此背景下,本综述总结归纳了血小板-肿瘤相互作用的病理特点和调控机制,并探讨了以鸡血藤为代表的活血化瘀中药在抗TCIPA治疗中的潜在价值,旨在引起人们对这一治疗思路的高度重视,对TCIPA研究进展形成体系化的认识,并对未来抗肿瘤药物研发提供策略和方向。

Effect of Tumor Cell-induced Platelet Aggregation in Tumor Metastasis and Application of Spatholobi Caulis

Due to the limitation of metastatic inhibitory therapies, metastasis has become the main cause of cancerous death clinically. Currently, increasing evidences have proved that the tumor cell-induced platelet aggregation (TCIPA) is the basis model for the interaction of metastatic tumor cells and platelets. By disturbing the physiological coagulation balance and maintaining the bidirectional pro-tumoral properties in hemato-microenvironment, TCIPA also functionally determines a series of crucial cascades for metastasis. On one hand, the formation of platelet aggregates surrounding tumor cells supports their survival and protects them against host immuno-elimination; on the other hand, activated platelets could in turn promote the tumor cell transportation along the bloodstream and finally enhance the colony formation within the distant organs. Spatholobi Caulis is a kind of classic traditional Chinese medicines of promoting blood circulation to remove blood stasis. Its effect in improving the hypercoagulable state has been recorded in lots of ancient Chinese medical books. In recent years, more and more reports have shown that it plays a key role in anti-tumor metastasis by regulating the blood microenvironment. In light of this, our review summarized the pathological characteristics and the regulation mechanism of platelet-tumor interaction. Additionally, we also discussed the potential value of anti-platelet drugs represented by Spatholobi Caulis, in order to provide the comprehensive anti-metastatic strategy. We wrote this review to highlight the significance and the systematic recognition of anti-TCIPA therapy. Moreover, we would provide a direction for the research and development of anti-metastatic drugs in the future.