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Pi (Spleen)-deficiency syndrome in tumor microenvironment is the pivotal pathogenesis of colorectal cancer immune escape

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Abstract

Cancer immunoediting consists of three sequential phases: elimination, equilibrium, and escape. For colorectal adenoma-carcinoma sequence, the adenoma dysplastic progression may represent an equilibrium phase and the cancer stage as escape phase. Immune system eliminates transformed enterocytes by destroying them at first, sculpts them at the same time and selects the variants subsequently that are no longer recognized and insensitive to immune effectors, and finally induces immunosuppressive state within the tumor microenvironment that facilitates immune escape and tumor outgrowth. Immunosuppression and inflammation are the two crucial features of Pi (Spleen)-deficiency. Classic quotations, immune evidence and clinical observations suggest that Spleen (but not other organs) deficiency is the key pathogenesis of colorectal cancer (CRC) microenvironment. Weakness of old age, immunosuppressive cytokines from chronic inflammation, tumor-derived immunosuppressive factors and surrendered immune cells—regulatory T cells, myeloid-derived suppressor cells and tumor associated macrophages (TAMs) constitutes CRC microenvironment of Pi-deficiency. Furthermore, excess in superficiality, such as phlegm stagnation, blood stasis and toxin accumulation are induced by chronic inflammation on the basis of asthenia in origin, an immunosuppressive state. Great masters of Chinese medicine emphasize that strengthen Pi is the chief therapeutic principle for CRC which receives good therapeutic effects. So, Pi-deficiency based syndrome is the pivotal pathogenesis of tumor microenvironment. The immunosuppressive microenvironment facilitates immune escape which play an important role in the transition from adenoma to adenocarcinoma. There are some signs that strengthen Pi based treatment has potential capacity to ameliorate tumor environment. It might be a novel starting point to explore the mechanism of strengthen Pi based therapy in the prevention and treatment of CRC through regulation of tumor environment and immunoediting.

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Authors and Affiliations

  1. Department of Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China

    Xue-gang Sun  (孙学刚)

  2. School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, China

    Xue-gang Sun  (孙学刚), Xiao-chang Lin  (林小常) & Jian-xin Diao  (刁建新)

  3. Center for Cancer and Inflammation Research, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, SAR, China

    Zhi-ling Yu  (禹志领)

  4. China Academy of Chinese Medical Sciences, Beijing, 100700, China

    Kun Li  (李 鲲)

Authors
  1. Xue-gang Sun  (孙学刚)
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  2. Xiao-chang Lin  (林小常)
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  3. Jian-xin Diao  (刁建新)
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  4. Zhi-ling Yu  (禹志领)
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  5. Kun Li  (李 鲲)
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Corresponding author

Correspondence to Kun Li  (李 鲲).

Additional information

Supported by the National Natural Science Foundation of China (No. 81273621), Guangdong Natural Science Foundation of China (No. 2014A030313323)

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Sun, Xg., Lin, Xc., Diao, Jx. et al. Pi (Spleen)-deficiency syndrome in tumor microenvironment is the pivotal pathogenesis of colorectal cancer immune escape. Chin. J. Integr. Med. 22, 789–794 (2016). https://doi.org/10.1007/s11655-015-2086-5

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  • DOI: https://doi.org/10.1007/s11655-015-2086-5

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