中医药调控银屑病相关信号通路研究进展

Psoriasis-related Signaling Pathways Regulated by Traditional Chinese Medicine:A Review

银屑病作为一种患病率逐渐攀升的炎症性皮肤病,给患者的生活质量带来很多负面影响,已引起医学界的广泛重视。银屑病可受遗传、环境、免疫等多种病因刺激而发病,以细胞因子驱动的表皮增生、异常分化、炎症和新血管生成为主要发病机制,涉及免疫和皮肤细胞的相互作用,但有些发病机制仍是研究的盲点,给临床治疗带来极大挑战,因此,探寻有效治疗靶点成为研究银屑病的重要目标。信号通路在银屑病的病理机制中承担重要细胞转导作用,是调控银屑病免疫和炎症反应的关键转导因子,是研究银屑病的热点领域。而中医药调控银屑病以其治疗通路广、作用靶点全且不良反应小等优势占据重要治疗地位,且随着网络药理学和分子生物学领域研究的深入,中药单体及中药复方可通过调控银屑病多条信号通路而发挥治疗作用。近年来,中医药防治银屑病已收获较好的临床疗效,可有效减轻瘙痒症状、减少皮损面积、改善焦虑情绪、预防并发症等,证明银屑病在中医研究领域的认识和辨证论治的正确性。尽管中医药在银屑病防治方面的理论与临床研究颇丰,但中医药对调控银屑病相关信号通路及作用机制方面的综述暂未见刊载。因此,该综述通过检索近几年国内外相关文献资料,介绍中医药调控银屑病相关的6条主要信号通路,即Janus酪氨酸蛋白激酶(JAK)/信号转导及转录激活因子(STAT)信号通路,丝裂原活化蛋白激酶(MAPK)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,Wnt信号通路,Notch信号通路。

As an inflammatory skin disease with a gradually increasing prevalence,psoriasis has negatively impacted the quality of life of patients and has attracted widespread attention from the medical community. The pathogenesis of psoriasis can be affected by a variety of genetic,environmental,and immune factors, and cytokine-driven epidermal proliferation, abnormal differentiation, inflammation, and neovascularization contribute to the pathogenesis,involving the interaction between immune and skin cells.However,some pathogenesis is still a blind spot for research,which brings great challenges to clinical treatment.Therefore,the identification of effective targets for psoriasis is critical in the research on psoriasis. Signaling pathways,another hotpot in the research on psoriasis,play an important cellular transduction role in the pathological mechanism of psoriasis and serve as key transduction factors regulating the immune and inflammatory responses to psoriasis. With the in-depth research in the field of network pharmacology and molecular biology,single Chinese medicine and Chinese medicinal compound can exert a therapeutic role by regulating multiple signaling pathways related to psoriasis. In recent years,traditional Chinese medicine(TCM)has achieved good clinical efficacy in the prevention and treatment of psoriasis,such as relieving pruritus,decreasing the area of skin lesions,improving anxiety,and preventing complications,which confirms the credibility of TCM in the understanding and treatment of psoriasis. Despite the rich theoretical and clinical research on the prevention and treatment of psoriasis,studies on the regulation of psoriasis-related signaling pathways and mechanisms of action by TCM are rarely reported. Therefore,the present study reviewed the available research in recent years and introduced the following six major signaling pathways related to psoriasis which are regulated by TCM: Janus kinase(JAK)/signal transducer and activator of transcription(STAT)signaling pathway,mitogen-activated protein kinase(MAPK)signaling pathway,phosphatidylinositol-3-kinases(PI3 K)/protein kinase B(Akt)signaling pathway,nuclear transcription factor-κB(NF-κB)signaling pathway,Wnt signaling pathway,and Notch signaling pathway.