摘要
桥本甲状腺炎(HT)是一种由细胞和抗体介导的自身免疫性疾病。该病发病机制尚不明确,主要与遗传因素和环境因素密切相关。其特征是B细胞功能障碍、异常的T细胞亚群破坏免疫稳态、导致甲状腺自身抗体和甲状腺组织的损伤。西医临床治疗的主流是甲状腺激素替代疗法。这种方法在一定程度上有效,但疗效不稳定,不良反应较多且复发率高,加重了患者的负担。近年来,中医药在治疗HT方面取得了一定的进展。中医药干预HT具有途径广泛、靶点良多、简验廉效、不良反应小等优势。多项研究表明,中药单体及复方可以通过作用于甲状腺细胞的多个靶点,调节与疾病相关的信号通路来抑制炎症反应、氧化应激、细胞自噬、细胞凋亡、铁死亡和内质网应激等病理过程,从而减轻自身免疫反应,延缓疾病的进展。因此,该文总结出中医药干预HT的主要信号通路[磷脂酰肌醇3-激酶(PI3K)/蛋白激酶B(Akt)信号通路、核转录因子-κB(NF-κB)信号通路、Notch信号通路、丝裂原活化蛋白激酶(MAPK)信号通路、NOD样受体蛋白3(NLRP3)/胱天蛋白酶-1(Caspase-1)信号通路、蛋白激酶R-like内质网激酶(PERK)/转录激活因子4(ATF4)/内质网应激(CHOP)信号通路、趋化因子配体2(CCL2)/趋化因子受体2(CCR2)信号通路]以飨同道,为新药研发提供一定的参考方向。
Hashimoto's thyroiditis(HT)is an autoimmune disease mediated by cells and antibodies.The pathogenesis of this disease is not clear,and it is mainly closely related to genetic and environmental factors.It is characterized by B-cell dysfunction and disruption of immune homeostasis by abnormal T-cell subsets,which result in damage to thyroid autoantibodies and thyroid tissue.The mainstream of Western clinical treatment is thyroid hormone replacement therapy.This method is effective to a certain extent,but the efficacy is unstable,with more adverse reactions and a high recurrence rate,which aggravates the burden on patients.In recent years,traditional Chinese medicine(TCM)has made some progress in the treatment of HT.The intervention of TCM in HT has the advantages of a broad pathway,many targets,a simple and inexpensive effect,and small side effects.Several studies have shown that TCM monomers and compounds can inhibit pathological processes such as inflammatory response,oxidative stress,cellular autophagy,apoptosis,ferroptosis,and endoplasmic reticulum stress by acting on multiple targets in thyroid cells and modulating disease-related signaling pathways,thereby attenuating autoimmune responses and slowing down the progression of the disease.Therefore,this paper summarized the main signaling pathways of TCM intervention in HT[phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt)signaling pathway,nuclear transcription factor-κB(NF-κB)signaling pathway,Notch signaling pathway,mitogen-activated protein kinase(MAPK)signaling pathway,NOD-like receptor protein 3(NLRP3)/cysteine-containing aspartic protein Caspase-l signaling pathway,protein kinase R-like endoplasmic reticulum kinase(PERK)/activating factor for transcription 4(ATF4)/endoplasmic reticulum stress(CHOP)signaling pathway,and chemokine ligand 2(CCL2)/chemokine receptor 2(CCR2)signaling pathway],aiming to provide a certain reference for the development of new drugs.
作者
肖艳琪
裴瑞霞
郑艳
王金仙
XIAO Yanqi;PEI Ruixia;ZHENG Yan;WANG Jinxian(Shaanxi University of Chinese Medicine,Xianyang 712046,China;Xi'an Hospital of Traditional Chinese Medicine,Xi'an 710021,China)
出处
《中国实验方剂学杂志》
北大核心
2025年第23期237-247,共11页
Chinese Journal of Experimental Traditional Medical Formulae
基金
高上林全国名中医传承工作室建设项目(国中医药人教发[2011]41号)
秦晋高氏内科学术流派传承工作室建设项目(陕中医药发[2018]40号)
西安市首届名中医裴瑞霞传承工作室建设项目(市卫计发[2017]334号)。
关键词
中医药
桥本甲状腺炎
信号通路
作用机制
研究进展
traditional Chinese medicine
Hashimoto's thyroiditis
signaling pathway
mechanism of action
research progress
