Heat-sensitive Moxibustion Enhances Immunity in Advanced Non-small Cell Lung Cancer via Th1/Th2 and Treg/Th17 Regulation.

Background: Patients with advanced non-small cell lung cancer (NSCLC) often experience poor clinical outcomes following chemotherapy. Heat-sensitive moxibustion (HSM), a traditional therapeutic intervention, has been reported to improve symptoms and quality of life in patients with cancer. Objective: To evaluate the effect of HSM in patients with advanced NSCLC following chemotherapy. Methods: Between January 2023 and February 2024, patients with advanced NSCLC were enrolled. Eligible patients were randomly assigned to either the chemotherapy (control) group or the chemotherapy plus HSM treatment (HSM) group. Following treatment, the percentages of CD4+ T cell subsets were evaluated, and the serum levels of CD4+ T cells-associated cytokines were measured using enzyme-linked immunosorbent assay (ELISA). The expression levels of CD4+ T cells-related factors were assessed by RT-qPCR and Western blot analysis. The overall response rate (OPR) and disease control rate (DCR), Karnofsky Performance Status (KPS) score, and incidence of adverse events were compared between the two groups. Results: A total of 90 patients with NSCLC were included with 45 patients in each group. The ratio of Th1/Th2 was significantly elevated, whereas the Treg/Th17 ratio was significantly decreased in the HSM group compared with the control group. The HSM group exhibited higher serum levels of IL-2, IL-17A and IFN-γ, and lower levels of IL-4 and IL-10 than the control group. HSM treatment significantly upregulated the expression of T-bet and IL-17A while downregulating GATA3 expression at both the mRNA and protein levels. The HSM group demonstrated superior clinical outcomes, as evidenced by higher KPS score, ORR, DCR, along with a lower incidence of adverse events. Conclusion: HSM may enhance immune function in patients with advanced NSCLC undergoing chemotherapy by modulating the balance of Th1/Th2 and Treg/Th17 cell subsets.