Objective To systematically summarize the role of immune cells in the progression of anastomotic leak (AL) following colorectal cancer (CRC) surgery, with an emphasis on the molecular mechanisms of metabolic reprogramming in relevant immune cells, aiming to provide new insights for the diagnosis and treatment of AL. Method We reviewed recent literature on the metabolic reprogramming of immune cells in AL following CRC surgery. Results In the postoperative CRC AL microenvironment, homeostasis imbalance drives metabolic reprogramming of immune cells (macrophages, neutrophils), manifested as enhanced glycolysis, impaired fatty acid oxidation, and tricarboxylic acid cycle disruption. Accumulated metabolites (lactate, succinate), along with acidic pH, hypoxia, and immune factors, collectively shape an intertwined immunosuppressive and pro-inflammatory microenvironment that impedes anastomotic healing. Targeting key nodes in this metabolic reprogramming offers potential therapeutic strategies and a theoretical framework for clinical translation in AL. Conclusions Immune cells, as key components of the AL microenvironment, play an important role in the initiation and progression of AL. In-depth exploration of the molecular mechanisms underlying metabolic reprogramming of relevant immune cells may provide directions for the diagnosis and treatment of AL, with the aim of improving patients’ outcomes.
Citation：
JIA Xiahe, XU Jianjiang, MA Mingli, CHEN Tao, YAN Junqian, JIANG Lei. Mechanisms of immune cell metabolic reprogramming in the microenvironment of anastomotic leak after colorectal cancer surgery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2026, 33(6): 846-855. doi: 10.7507/1007-9424.202601151
Copy
Copyright ? the editorial department of CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY of West China Medical Publisher. All rights reserved
| 1. |
|
| 2. |
|
| 3. |
|
| 4. |
|
| 5. |
|
| 6. |
|
| 7. |
|
| 8. |
|
| 9. |
|
| 10. |
|
| 11. |
|
| 12. |
|
| 13. |
|
| 14. |
|
| 15. |
|
| 16. |
|
| 17. |
Van den Bossche J, O’Neill LA, Menon D. Macrophage immunometabolism: where are we (going)? Trends Immunol, 2017, 38(6): 395-406.
|
| 18. |
|
| 19. |
|
| 20. |
|
| 21. |
|
| 22. |
|
| 23. |
|
| 24. |
|
| 25. |
|
| 26. |
|
| 27. |
|
| 28. |
|
| 29. |
|
| 30. |
|
| 31. |
|
| 32. |
|
| 33. |
|
| 34. |
|
| 35. |
|
| 36. |
|
| 37. |
|
| 38. |
|
| 39. |
|
| 40. |
|
| 41. |
|
| 42. |
|
| 43. |
|
| 44. |
Pucino V, Certo M, Bulusu V, et al. Lactate buildup at the site of chronic inflammation promotes disease by inducing CD4+ T cell metabolic rewiring. Cell Metab, 2019, 30(6): 1055-1074.e8.
|
| 45. |
Chapman NM, Shrestha S, Chi H. Metabolism in immune cell differentiation and function// Li B, Pan F. Advances in experimental medicine and biology. Cham: Springer, 2017: 1-85.
|
| 46. |
|
| 47. |
|
| 48. |
|
| 49. |
|
| 50. |
|
| 51. |
|
| 52. |
|
| 53. |
|
| 54. |
|
| 55. |
|
| 56. |
|
| 57. |
|
| 58. |
|
| 59. |
|
| 60. |
|
| 61. |
|
| 62. |
Chan MC, Holt-Martyn JP, Schofield CJ, et al. Pharmacological targeting of the HIF hydroxylases–a new field in medicine development. Mol Aspects Med, 2016, 47-48: 54-75.
|
| 63. |
|
| 64. |
|
| 65. |
|
| 66. |
|
| 67. |
|
- 1.
- 2.
- 3.
- 4.
- 5.
- 6.
- 7.
- 8.
- 9.
- 10.
- 11.
- 12.
- 13.
- 14.
- 15.
- 16.
- 17. Van den Bossche J, O’Neill LA, Menon D. Macrophage immunometabolism: where are we (going)? Trends Immunol, 2017, 38(6): 395-406.
- 18.
- 19.
- 20.
- 21.
- 22.
- 23.
- 24.
- 25.
- 26.
- 27.
- 28.
- 29.
- 30.
- 31.
- 32.
- 33.
- 34.
- 35.
- 36.
- 37.
- 38.
- 39.
- 40.
- 41.
- 42.
- 43.
- 44. Pucino V, Certo M, Bulusu V, et al. Lactate buildup at the site of chronic inflammation promotes disease by inducing CD4+ T cell metabolic rewiring. Cell Metab, 2019, 30(6): 1055-1074.e8.
- 45. Chapman NM, Shrestha S, Chi H. Metabolism in immune cell differentiation and function// Li B, Pan F. Advances in experimental medicine and biology. Cham: Springer, 2017: 1-85.
- 46.
- 47.
- 48.
- 49.
- 50.
- 51.
- 52.
- 53.
- 54.
- 55.
- 56.
- 57.
- 58.
- 59.
- 60.
- 61.
- 62. Chan MC, Holt-Martyn JP, Schofield CJ, et al. Pharmacological targeting of the HIF hydroxylases–a new field in medicine development. Mol Aspects Med, 2016, 47-48: 54-75.
- 63.
- 64.
- 65.
- 66.
- 67.
1/5
WeChat