中医药调控TLR4/NF-κB信号通路治疗帕金森病的研究进展

Traditional Chinese Medicine in Treatment of Parkinson's Disease by Regulating TLR4/NF-κB Signaling Pathway:A Review

帕金森病(PD)是一种以黑质多巴胺能神经元进行性退变和路易小体形成为病理变化的常见的中老年神经系统退行性疾病,患病率高且病程长。西医治疗PD以药物为主,早期疗效显著;但随着疾病进展和药物的长期使用,药效会明显减退,或可出现运动并发症等,远期疗效欠佳。中医药作为一种传统的医学体系,对帕金森病有着独特的认识。中药在PD的治疗中发挥着重要的作用,其具有天然、温和、安全有效的特点,可以与西药相配合,协同增强疗效、减轻西药的不良反应。PD发病机制复杂,涉及线粒体功能障碍、细胞凋亡等多个层面,神经炎症也参与PD的多巴胺能神经元的进行性退化。Toll样受体4(TLR4)/核转录因子-κB(NF-κB)信号通路是经典的炎症通路,其表达变化在机体炎性反应发生发展过程中发挥重要作用,近年来中医药在该通路方面的研究日渐增多。笔者对近10年中西医文献进行总结梳理,从中药单体、复方、其他中医疗法方面围绕中医药调控TLR4/NF-κB通路治疗PD的相关作用机制进行综述,以期为寻找药物治疗和基因治疗的新靶点,及中医药防治PD的深入研究提供一些参考。

Parkinson's disease(PD)is a common neurological degenerative disease in the middle-aged and elderly,characterized by pathological changes of progressive degeneration of dopaminergic neurons in the substantia nigra and Lewy body formation,with high prevalence and long course of disease.The drug is mainly used to treat PD in western medicine,and the early curative effect is remarkable.However,with the progression of the disease and the long-term use of the drug,the efficacy will be significantly reduced,or there may be sports complications,and the long-term efficacy is not good.As a traditional medical system,traditional Chinese medicine has a unique understanding of PD.Traditional Chinese medicine plays an important role in the treatment of PD,which is natural,mild,safe,and effective,and it can cooperate with western medicine to enhance its efficacy and reduce the adverse reactions of western medicine.The pathogenesis of PD is complex,involving multiple levels such as mitochondrial dysfunction and apoptosis.Neuroinflammation is also involved in the progressive degeneration of dopaminergic neurons in PD.The Toll-like receptor 4(TLR4)/nuclear factor-κB(NF-κB)signaling pathway is a classic inflammatory pathway,and its expression changes play an important role in the occurrence and development of inflammatory response in the body.In recent years,the research on this pathway in TCM is increasing.This paper summarized the literature of traditional Chinese and western medicine in the past 10 years and reviewed the relevant mechanism of TCM regulation of TLR4/NF-κB pathway in the treatment of PD from the aspects of TCM monomer,compound,and other TCM therapies,so as to provide some references for the search for new targets of drug therapy and gene therapy and the in-depth study of TCM prevention and treatment of PD.