线粒体作为中药治疗心力衰竭靶点的研究进展

Research progress of mitochondria as target of traditional Chinese medicines in treatment of heart failure

心力衰竭作为各种心血管疾病发展的最终阶段,是全世界发病率和死亡率最高的疾病之一,由于其发病机制复杂多样,人们迫切需要发现新的靶标和相应的治疗方法。心肌能量代谢失衡是心力衰竭的重要分子生物学基础,严重影响着心脏的收缩和舒张功能。线粒体作为心肌细胞内能量合成的主要来源和细胞内多种信号通路的重要参与者,在细胞的存活和死亡的过程中扮演着不可或缺的角色,是治疗心力衰竭的重要靶点。中医药具有多成分、多靶点、多途径的作用特点,在治疗心力衰竭方面具有显著的疗效。近年来,越来越多的研究将线粒体作为中医药治疗心力衰竭的靶标,在改善线粒体功能、提高心肌细胞能量代谢水平、增加心肌细胞的能量供应、抗氧化应激等方面取得了一定的成果。该文从线粒体生物发生、线粒体电子传输链和活性氧(ROS)产生、代谢底物和代谢酶、线粒体内钙离子转运4个方面将近年来中医药调节线粒体治疗心力衰竭的研究进行归纳和评述,为后续进一步的基础研究及临床应用提供依据和思路。

As the final destination of various cardiovascular abnormalities,heart failure is one of the diseases with the highest morbidity and mortality in the world.Due to its complicated pathogenesis,people urgently need to find new targets and effective treatment.Imbalance in myocardial energy metabolism,an important molecular biological basis for heart failure,affects the contractile and diastolic functions of the heart.As the main source of energy synthesis in cardiomyocytes and an important participant in various signaling pathways,mitochondria plays an indispensable role in the process of cell survival and death and has been considered as a critical target for the treatment of heart failure.Traditional Chinese medicine has a great effect on the treatment of heart failure through multi-components,multi-targets,and multi-channels.In recent years,more and more researches regard mitochondria as the target of traditional Chinese medicine in the treatment of heart failure,and have achieved significant results in improving mitochondrial function,increasing energy metabolism and energy supplement for cardiomyocytes,and resisting against oxidative stress.In this article,researches on the regulation of mitochondria in the treatment of heart failure by traditional Chinese medicine are reviewed from four aspects:mitochondrial biogenesis;mitochondrial electron transport chain and reactive oxygen species(ROS)production;metabolic substrates and metabolic enzymes;and calcium ion transport in the mitochondria.It provides a basis for further research and clinical application in the future.