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<article article-type="review-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">sibmed</journal-id><journal-title-group><journal-title xml:lang="ru">Сибирский научный медицинский журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Сибирский научный медицинский журнал</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2410-2512</issn><issn pub-type="epub">2410-2520</issn><publisher><publisher-name>ИЦиГ СО РАН</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.18699/SSMJ20260201</article-id><article-id custom-type="elpub" pub-id-type="custom">sibmed-2818</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS</subject></subj-group></article-categories><title-group><article-title>Раковая нервная система: переосмысление онкологии через нарушение нейрональных связей</article-title><trans-title-group xml:lang="en"><trans-title>The cancer nervous system rewiring oncology through neural disruption</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5480-1688</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Акль</surname><given-names>М. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Akl</surname><given-names>M. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Акль Махер М.</p><p>603022, г. Нижний Новгород, пр. Гагарина, 23</p></bio><bio xml:lang="en"><p>Maher M. Akl</p><p>603022, Nizhny Novgorod, Gagarina ave., 23</p></bio><email xlink:type="simple">maherakl555@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3477-236X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ахмед</surname><given-names>А.</given-names></name><name name-style="western" xml:lang="en"><surname>Ahmed</surname><given-names>A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ахмед Амр</p><p>13524, г. Эр-Рияд, ш. короля Фахда, 4499</p></bio><bio xml:lang="en"><p>Amr Ahmed</p><p>13524, Riyadh, King Fahd Rd., 4499 </p></bio><email xlink:type="simple">drmedahmed@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Нижегородский государственный университет им. Н.И. Лобачевского</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Lobachevsky State University of Nizhny Novgorod</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Департамент общественного здравоохранения Первого медицинского объединения Эр-Рияда</institution><country>Саудовская Аравия</country></aff><aff xml:lang="en"><institution>The Public Health Department, Riyadh First Health Cluster</institution><country>Saudi Arabia</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>05</day><month>05</month><year>2026</year></pub-date><volume>46</volume><issue>2</issue><fpage>4</fpage><lpage>10</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Акль М.М., Ахмед А., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Акль М.М., Ахмед А.</copyright-holder><copyright-holder xml:lang="en">Akl M.M., Ahmed A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://sibmed.elpub.ru/jour/article/view/2818">https://sibmed.elpub.ru/jour/article/view/2818</self-uri><abstract><p>Рак все чаще рассматривается как нейробиологически интегрированное образование, а не просто совокупность пролиферирующих клеток. В данной статье вводится концепция раковой нервной системы (CNSy) ‒ динамичной самообеспечивающейся нейронной сети внутри опухолевой микросреды, регулирующей онкогенное поведение. Опухолевые клетки используют адренергические, холинергические и глутаматергические сигнальные пути для регуляции пролиферации, избегания иммунного надзора и метастазирования, имитируя физиологические нейронные цепи. Данные нейрофиламентного окрашивания, пространственной транскриптомики и молекулярного профилирования выявляют de novo нейрогенез в опухолях, что свидетельствует об активном взаимодействии между раком и нервной системой хозяина. Помимо локальных взаимодействий, опухоли координируют системный контроль над отдаленными метастазами через нейрохимические сигналы, экзосомную коммуникацию и каскады воспалительных цитокинов. Нарушение этого нейроонкологического взаимодействия представляет собой изменение парадигмы в терапии рака. Фармакологическое вмешательство, направленное на ингибирование β-адренергической сигнализации, например, использование β-блокаторов, демонстрирует потенциал в подавлении прогрессии опухоли и улучшении клинических исходов. Однако терапевтические стратегии должны выходить за рамки традиционных цитотоксических подходов и включать нейромодуляцию как ключевой элемент онкологии. Этот подход бросает вызов традиционному представлению о раке как о локализованном заболевании, переосмысливая его как нейромодулируемое злокачественное новообразование с внутренней связью с нервной системой. Интеграция нейронауки в онкологию через модель CNSy предоставляет новую основу для понимания поведения опухолей и разработки таргетных методов терапии, нарушающих нейронный вклад в злокачественный процесс. Осознание роли нервной системы в динамике опухолей не только углубляет понимание биологии рака, но и открывает новые возможности для персонализированной медицины.</p></abstract><trans-abstract xml:lang="en"><p>Cancer is increasingly recognized as a neurobiologically integrated entity rather than a mere collection of proliferative cells. This manuscript introduces the concept of the Cancer Nervous System (CNSy) ‒ a dynamic, self-sustaining neural network within the tumor microenvironment that governs oncogenic behavior. Malignant cells exploit adrenergic, cholinergic, and glutamatergic signaling pathways to regulate proliferation, immune evasion, and metastatic dissemination, mirroring physiological neural circuits. Evidence from neurofilament staining, spatial transcriptomics, and molecular profiling reveals de novo neurogenesis within tumors, suggesting an active interplay between cancer and the host nervous system. Beyond local interactions, tumors orchestrate systemic control over distant metastases through neurochemical signaling, exosomal communication, and inflammatory cytokine cascades. Disrupting this neuro-oncological axis presents a paradigm shift in cancer therapy. Pharmacological interventions targeting β-adrenergic signaling, such as β-blockers, have demonstrated potential in attenuating tumor progression and improving clinical outcomes. However, therapeutic strategies must evolve beyond conventional cytotoxic approaches to encompass neural modulation as a cornerstone of oncology. This perspective challenges the traditional view of cancer as a localized disease, reframing it as a neuromodulated malignancy with intrinsic connectivity to the nervous system. By integrating neuroscience into oncology, the CNSy model provides a novel framework for understanding tumor behavior and developing targeted therapies that disrupt neural contributions to malignancy. Recognizing the nervous system’s role in tumor dynamics not only advances our understanding of cancer biology but also unveils new opportunities for precision medicine</p></trans-abstract><kwd-group xml:lang="ru"><kwd>раковая нервная система</kwd><kwd>нейробиология опухолей</kwd><kwd>нейрональная сигнализация</kwd><kwd>нейроонкология</kwd><kwd>адренергическая сигнализация</kwd></kwd-group><kwd-group xml:lang="en"><kwd>Cancer Nervous System</kwd><kwd>tumor neurobiology</kwd><kwd>neural signaling</kwd><kwd>neuro-oncology</kwd><kwd>adrenergic signaling</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Keough M.B., Monje M. Neural signaling in cancer. Annu. Rev. Neurosci. 2022;45:199–221. doi: 10.1146/annurev-neuro-111020-092702</mixed-citation><mixed-citation xml:lang="en">Keough M.B., Monje M. Neural signaling in cancer. Annu. Rev. 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