黄芪多糖通过调节肠道菌群增敏PD-1抑制剂的研究进展

Research Progress on Astragalus Polysaccharide Sensitizing PD-1 Inhibitors by Modulating Intestinal Flora

摘要: 程序性细胞死亡蛋白1 (programmed cell death protein-1, PD-1)抑制剂在肿瘤免疫治疗中面临耐药性强、应答率低的挑战。黄芪多糖(astragalus polysaccharide, APS)具有抑制肿瘤细胞增殖，调节免疫等功能，还可能通过调节肠道菌群增强PD-1抑制剂疗效。本文综述了APS通过富集双歧杆菌、阿克曼菌等有益菌群，促进短链脂肪酸等代谢物分泌，从而增强肠道屏障功能、下调肿瘤PD-L1表达等多通路机制。APS通过“肠道菌群–免疫–肿瘤”轴改善肿瘤微环境，为PD-1抑制剂耐药提供新策略，但其临床转化仍需深入探索菌群调控的个体化差异及机制协同性。

Abstract: Programmed cell death protein-1 (PD-1) inhibitors face the challenge of strong drug resistance and low response rate in tumor immunotherapy. Astragalus polysaccharides (APS) have the functions of inhibiting tumor cell proliferation, regulating immunity, and may also enhance the efficacy of PD-1 inhibitors by modulating the intestinal flora. In this paper, APS promotes the secretion of short-chain fatty acids and other metabolites by enriching beneficial bacteria such as Bifidobacterium and Ackermania, thereby enhancing intestinal barrier function and down-regulating tumor PD-L1 expression. APS improves the tumor microenvironment through the “gut microbiota-immune-tumor” axis and provides a new strategy for PD-1 inhibitor resistance, but its clinical translation still needs to explore the individualized differences and mechanism synergies of microbiota regulation.