摘要
肾间质纤维化(RIF)是多种慢性肾病发展到终末期的共同病理变化过程,也是肾脏功能衰退的重要组织学表现。目前,临床尚未发现抗纤维化的有效药物。近年来随着中药药理学、分子生物学、系统生物学和网络药理学的不断发展,中药单体、单味中药、中药复方、中成药、中药注射液等调控RIF的研究日趋深入。其中以补益脾肾为主的健脾益肾方、参地补肾胶囊、建中补肾消癥汤、六味地黄汤、枸杞多糖等能调控转化生长因子-β_(1)(TGF-β_(1))/Smads、分泌型糖蛋白/β-连环蛋白(Wnt/β-catenin)和神经源性位点缺口同源蛋白(Notch)等信号通路;以利水为主的五苓散、真武汤及茯苓中茯苓酸ZA、茯苓酸ZC和茯苓酸ZD等的多种有效成分均可调控Wnt/β-catenin信号通路;以活血化瘀为主的水蛭素、姜黄素和扶正化瘀方能抑制核转录因子-κB(NF-κB)、Toll样受体4(TLR4)/NF-κB和Janus酪氨酸激酶2/信号转导和转录激活因子3(JAK2/STAT3)等炎症相关通路,达到抗炎、抗氧化,缓解RIF进展;以补气化瘀泄浊为主的肾衰泄浊汤、肾康注射液、肾衰方等能通过血管内皮生长因子受体(VEGFR)信号通路,抑制周细胞-肌成纤维细胞转分化。目前,关于中药调控RIF信号通路的研究众多,但缺乏系统总结。该研究通过梳理中医药治疗RIF的信号通路,筛选中药治疗的有效靶点,寻找其可能的作用机制,为临床治疗和新药研发提供新思路。
Renal interstitial fibrosis(RIF)is a common pathological change process from the development of various chronic nephropathies to the end stage,and it is an important histological manifestation of renal function decline.At present,no effective anti-fibrosis drugs have been found in clinical practice.In recent years,with the continuous development of traditional Chinese medicine(TCM)pharmacology,molecular biology,system biology,and network pharmacology,the research on regulating RIF with TCM monomer,single TCM,TCM compound,Chinese patent medicine,and TCM injection is deepening.Among them,Jianpi Yishen recipe,Shendi Bushen capsules,Jianzhong Bushen Xiaozheng decoction,Liuwei Dihuangtang,and Lycium barbarum polysaccharides can regulate transforming growth factor-β/small mother against decapentaplegic(TGF-β_(1)/Smads),Wnt/β-catenin,and neurogenic locus notch homolog protein(Notch)signaling pathways.Wulingsan,Zhenwutang,pachymic acid ZA,pachymic acid ZC,and pachymic acid ZD,which mainly induce diuresis,can regulate the Wnt/β-catenin signaling pathway.Hirudin,curcumin,and Fuzheng Huayu recipe,which mainly promote blood circulation,can inhibit inflammation-related pathways such as p-nuclear transcription factor-κB(NF-κB),Toll-like receptor 4/p-nuclear transcription factor-κB(TLR4/NF-κB),and Janus kinase 2/signal transducer and activator of transcription 3(JAK/STAT),so as to achieve antiinflammatory and anti-oxidation effects and alleviate the progression of RIF.Shenshuai Xiezhuo decoction,Shenkang injection,and Shenshuai recipe,which are mainly used for invigorating Qi,removing blood stasis,and removing turbidity,can inhibit transdifferentiation of pericytes-myofibroblasts through vascular endothelial growth factor receptor(VEGFR)signaling pathway.At present,there are many studies on the regulation of the RIF signaling pathway by TCM,but there is a lack of a systematic summary.In this study,by combing the signaling pathway of TCM in the treatment of RIF,the effective target of TCM treatment is screened,and its possible mechanism is found,which provides new ideas for clinical treatment and new drug research and development.
作者
魏丹丹
李闪闪
王永杰
王红玲
吴宗耀
王庆波
WEI Dandan;LI Shanshan;WANG Yongjie;WANG Hongling;WU Zongyao;WANG Qingbo(The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China;The First Clinical Medical College of Henan University of Chinese Medicine,Zhengzhou 450000,China;The Third People's Hospital of Henan Province,Zhengzhou 450000,China;Henan Province Staff Hospital,Zhengzhou 450000,China;Xizang University Tibetan Medicine,Lhasa 850000,China)
出处
《中国实验方剂学杂志》
北大核心
2025年第16期254-265,共12页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家自然科学基金青年基金项目(82204971)
河南省科技攻关项目(242102311264)
第七批全国老中医药专家学术经验继承项目(国中医药办人教函[2021]272号)
全国老中医药专家刘永业传承工作室建设项目(国中医药人教函[2022]75号)
河南省中西医学免疫工程研究中心项目(豫发改高技【2020】701号)
河南省联合共建项目(LHGJ20210266)
河南省中医药科学研究专项(2022JDZX121)
河南省文化与管理项目(TCM2022014)。
关键词
肾间质纤维化
中医药
信号通路
作用机制
研究进展
renal interstitial fibrosis
traditional Chinese medicine
signaling pathway
mechanism of action
research progress
