摘要
随着医学研究不断深入,人们越发认识到人体是一个内部高度协调的复杂系统,疾病的发生和发展往往涉及多个子系统(器官、组织、细胞等)之间的相互作用。传统主要基于孤立子系统的药理学研究理论和范式,通常更多关注药物与疾病器官分子靶标的直接对抗作用,在应对代谢相关疾病、自身免疫性疾病、肿瘤、衰老等复杂疾病时尚面临挑战。近年来,器官对话在疾病发生发展的重要性不断被发现,为探讨药物通过对多个器官系统的整体调控来治疗复杂疾病提供了重要启发,而药物干预具有跨器官效应的现象也不断被发现和证实。中医药的系统观治疗理念和相应的治则治法,如五脏相生相克、脏腑经络表里、脏病治腑、母病治子、上病下治等,为探究器官对话的途径和分子机制,提供了系统观思维方式和临床实证经验的有力指导。为此,该文在前期提出的中药间接调控作用的基础上,进一步提出中间媒介物质介导的间接药理学(indirect pharmacology)作为经典药理学的新拓展,探讨药物干预的跨器官效应和机制,以期为更好地理解器官对话和发现跨器官干预药物提供新视角和新思路。
With the continuous advancement of medical research,it is increasingly recognized that the human body functions as a highly coordinated complex system,and the development of diseases often involves intricate interactions among multiple subsystems,including organs,tissues,and cells.Conventional pharmacological research,which primarily focuses on isolated subsystems,tends to emphasize direct interactions between drugs and the molecular targets in diseased organs.However,this approach often falls short in addressing the multifaceted challenges posed by complex diseases such as metabolic disorders,autoimmune diseases,cancers,and aging.In recent years,inter-organ cross-talk and its role in diseases progression,as well as cross-organ effects of drug intervention,have gained significant attention.This has highlighted the potential for treating complex diseases through holistic regulation of multiple organs.Traditional Chinese medicine(TCM)has long embraced a holistic and systemic approach for treatment,with concepts such as the interdependence and mutual restraint of the five Zang organs,the interconnection of Zang organs and Fu organs,treating the Zang organ diseases by regulating the Fu organs,treating the child organ diseases to cure the parent organs,and treating upper organ diseases by regulating lower organs.These concepts provide valuable insights into exploring the pathways and molecular mechanisms underlying inter-organ cross-talk.Building on our previous work on indirect actions of TCM,this paper introduces the concept of indirect pharmacology mediated by intermediate substances,as a new extension of classical pharmacology.This approach aims to offer new perspectives and innovative ideas for understanding inter-organ cross-talk and discovering cross-organ therapeutic strategies.
作者
王伽伯
许海玉
杨洪军
肖小河
田金洲
WANG Jia-bo;XU Hai-yu;YANG Hong-jun;XIAO Xiao-he;TIAN Jin-zhou(School of Traditional Chinese Medicine,Capital Medical University,Beijing 100069,China;Institute of Chinese Materia Medica,China Academy of Chinese Medical Sciences,Beijing 100700,China;School of Pharmacy,Liaoning University of Traditional Chinese Medicine,Dalian 116600,China;Military Institute of Chinese Medicine,Chinese PLA General Hospital,Beijing 100039,China;Dongzhimen Hospital,Beijing University of Chinese Medicine,Bejing 100700,China)
出处
《中国中药杂志》
北大核心
2025年第13期3549-3555,共7页
China Journal of Chinese Materia Medica
基金
国家中医药管理局高水平中医药重点学科建设项目(ZYYZDXK-2023004)
北京市杰出青年科学基金项目(JQ21026)
国家自然科学基金联合基金重点项目(U21A20412)
国家自然科学基金面上项目(82474218)。
关键词
系统医学
间接作用
中间媒介物质
器官对话
跨器官干预
systems medicine
indirect action
intermediate substance
inter-organ cross-talk
cross-organ intervention
