Tumor immunotherapy is the fourth therapy after surgery, chemotherapy, and radiotherapy. It has made great breakthroughs in the treatment of some epithelial tumors and hematological tumors. However, its adverse reactions are common or even more serious, and the response rate in some solid tumors is not satisfactory. With the maturity of genomics and metabolomics technologies, the effect of intestinal microbiota in tumor development and treatment has gradually been recognized. The microbiota may affect tumor immunity by regulating the host immune system and tumor microenvironment. Some bacteria help fight tumors by activating immunity, while some bacteria mediate immunosuppression to help cancer cells escape from the immune system. More and more studies have revealed that the effects and complications of tumor immunotherapy are related to the composition of the gut microbiota. The composition of the intestinal microbiota that is sensitive to treatment or prone to adverse reactions has certain characteristics. These characteristics may be used as biomarkers to predict the prognosis of immunotherapy and may also be developed as “immune potentiators” to assist immunotherapy. Some clinical and preclinical studies have proved that microbial intervention, including microbial transplantation, can improve the sensitivity of immunotherapy or reduce adverse reactions to a certain extent. With the development of gene editing technology and nanotechnology, the design and development of engineered bacteria that contribute to immunotherapy has become a new research hotspot. Based on the relationship between the intestinal microbiota and immunotherapy, the correct mining of microbial information and the development of reasonable and feasible microbial intervention methods are expected to optimize tumor immunotherapy to a large extent and bring new breakthroughs in tumor treatment.

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肠道菌群在肿瘤免疫治疗中的作用

肿瘤免疫疗法是继手术、化学疗法和放射疗法之后的第四种疗法。在部分上皮性肿瘤和血液肿瘤的治疗上取得了重大突破。但其不良反应常见甚至更为严重，在部分实体瘤中的反应率并不理想。随着基因组学和代谢组学技术的成熟，肠道菌群在肿瘤发生发展和治疗中的作用逐渐得到认可。微生物群可能通过调节宿主免疫系统和肿瘤微环境来影响肿瘤免疫。一些细菌通过激活免疫来帮助对抗肿瘤，而一些细菌介导免疫抑制以帮助癌细胞逃离免疫系统。越来越多的研究表明，肿瘤免疫治疗的效果和并发症与肠道菌群的组成有关。对治疗敏感或易发生不良反应的肠道菌群组成具有一定的特点。这些特征可以作为生物标志物来预测免疫治疗的预后，也可以作为“免疫增强剂”来辅助免疫治疗。一些临床和临床前研究证明，微生物干预，包括微生物移植，可以在一定程度上提高免疫治疗的敏感性或减少不良反应。随着基因编辑技术和纳米技术的发展，有助于免疫治疗的工程菌的设计和开发成为新的研究热点。