摘要
慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)是一种以持续性气流受限和呼吸道症状为主要特征的常见呼吸系统疾病,临床表现为进行性呼吸困难伴慢性咳嗽咳痰,具有高发病率及突出的致死特征,对我国居民健康及社会经济造成沉重负担。Toll样受体4(Toll-Like Receptor 4,TLR4)作为天然免疫系统中的关键模式识别受体,可通过识别内外源性配体激活下游核转录因子-κB(Nuclear Factor-Kappa B,NF-κB)通路,进而启动并放大炎性反应,在COPD的疾病演进中发挥核心作用。近年研究表明,TLR4/NF-κB信号通路不仅参与气道炎症细胞浸润、促炎因子释放,还介导氧化应激损伤、蛋白酶表达失调及肺泡上皮细胞凋亡,是连接COPD多种病理改变的枢纽通路。中医药在防治COPD方面显示出多成分、多靶点、整体调节的独到优势。大量实验研究证实,多种中药活性成分及复方制剂可通过靶向调控TLR4/NF-κB信号通路抑制炎症因子释放、减轻氧化损伤、调节细胞凋亡、改善气道重塑,从而延缓COPD进展。通过解析TLR4/NF-κB信号传导机制及其在COPD发病中的关键作用,重点归纳了具有调控该通路潜力的中药单体及复方,并探讨其作用机制,以期为COPD的中医药防治提供新的理论依据和策略,也为中药新药的研发和临床精准用药提供方向。
Chronic obstructive pulmonary disease(COPD)is a prevalent respiratory disorder characterized by persistent airflow limitation and respiratory symptoms.Clinically,it manifests as progressive dyspnea accompanied by chronic cough and sputum production.With a high incidence rate and notable lethality,COPD imposes a substantial burden on the health of Chinese residents and the socioeconomic landscape.Toll-like receptor 4(TLR4),a pivotal pattern recognition receptor within the innate immune system,activates the downstream nuclear factor kappa B(NF-κB)pathway by recognizing both endogenous and exogenous ligands,thereby initiating and amplifying inflammatory responses and playing a central role in the progression of COPD.Recent studies have demonstrated that the TLR4/NF-κB signaling pathway is not only involved in airway inflammatory cell infiltration and pro-inflammatory cytokine release but also mediates oxidative stress damage,protease expression imbalance,and alveolar epithelial cell apoptosis,serving as a pivotal pathway linking various pathological alterations in COPD.Traditional Chinese medicine(TCM)exhibits unique advantages in preventing and treating COPD,characterized by its multi-component,multi-target,and holistic regulatory effects.Numerous experimental studies have confirmed that various active ingredients and compound formulations of Chinese medicinal can target and modulate the TLR4/NF-κB signaling pathway,thereby inhibiting inflammatory cytokine release,alleviating oxidative damage,regulating cell apoptosis,and improving airway remodeling,ultimately delaying the progression of COPD.This article elucidates the TLR4/NF-κB signaling transduction mechanism and its pivotal role in the pathogenesis of COPD,focusing on summarizing Chinese medicinal monomers and compound formulations with the potential to regulate this pathway and exploring their underlying mechanisms.The aim is to provide novel theoretical foundations and strategies for the prevention and treatment of COPD in TCM,as well as to offer directions for the development of new TCM drugs and precise clinical medication.
出处
《中医临床研究》
2025年第30期52-59,共8页
Clinical Journal Of Chinese Medicine
