自噬在轮状病毒性肠炎中的作用及中药干预研究进展

Role of Autophagy in Rotavirus Enteritis and Intervention with Traditional Chinese Medicine:A Review

轮状病毒性肠炎(RVE)是一种常见的消化系统传染病,一般多发于婴幼儿,全球发病率居高不下,危害较大。然而目前西医仅采取补液、止泻、纠正电解质紊乱、保护胃肠道黏膜、调节肠道微生态等对症治疗的方法而无特效药物,疗效相对缓慢,并且在预防RVE发病及缩短病程周期等方面存在一定缺陷。中医药治疗RVE具有多靶点、安全价廉效优等显著优势,但具体作用机制阐释不足,研究基础仍然十分薄弱。对于中药单体及其活性成分在RVE发病中的作用目前虽有一定数量的研究,但所涉及的种类仍较少,且其对自噬相关通路影响的研究缺乏大规模实验数据的支撑,实验研究及临床依据均不足。对于中药复方的相关研究则更为表浅,范围更加局限,存在诸多不可忽视的问题。自噬(autophagy)作为高度保守的生物学现象,涉及多种信号通路,其功能失调与多种病理过程有关。研究表明自噬在RVE发病中起重要作用,尤其是病毒感染初期。自噬可以通过肠黏膜屏障损伤、肠神经功能紊乱及机体免疫异常等机制,导致RVE的发生和发展。近年来大量实验研究证实,中药可通过干预自噬在循环、呼吸、消化、肿瘤、免疫等多系统疾病的治疗中发挥重要作用。同时,少量研究表明,中药单体及其活性成分、中药复方可通过干预相关信号通路调控自噬干预病毒复制,从而在RVE的发病及病情进展过程中发挥积极作用。然而目前针对中药调控自噬治疗RVE的研究较少,并且尚未有系统阐述,该文旨在通过对自噬在RVE发病中的作用及中药干预自噬治疗RVE等方面进行文献检索并加以分析,以期为中医药治疗RVE提供更多的理论和临床依据。

Rotavirus enteritis(RVE),a common infectious disease of the digestive system,is commonly found in infants and young children.Its incidence is high,posing great threats to human health.At present,no specific drugs are available in western medicine and the symptomatic treatments like fluid infusion,anti-diarrhea,correction of electrolyte disorder,protection of gastrointestinal mucosa,and regulation of intestinal microecology have been employed.In addition to the poor therapeutic efficacy,they do not perform well in preventing the onset of RVE and shortening the course of disease.Traditional Chinese medicine(TCM)exerts the therapeutic effect against RVE via multiple targets,without inducing obvious adverse reactions and the cost is low.The specific mechanism of action has yet to be fully explained.Although there are some studies exploring the role of Chinese medicinal monomers in the pathogenesis of RVE,the types involved are still not enough.The effects of Chinese medicinal monomers on autophagy-related pathways fail to be uncovered,which is attributed to the lack of large-scale experimental data and clinical evidence.There are also many problems that cannot be ignored in the related research of Chinese medicinal compounds,taking the superficial exploration and limited scope for instance.Autophagy is a highly conserved biological phenomenon that involves a variety of signaling pathways.Its dysfunction is related to multiple pathological processes.Studies have shown that autophagy plays an important role in the pathogenesis of RVE,especially in the early stage of viral infection.Autophagy induces intestinal mucosal barrier damage,intestinal nerve dysfunction,and immune abnormality,resulting in the occurrence and development of RVE.In recent years,a large number of experimental studies have confirmed that TCM fights against circulatory,respiratory,digestive,and immune system diseases as well as tumors by intervening in autophagy.At the same time,a handful of studies have suggested that Chinese medicinal monomers and compounds regulate autophagy and interfere with viral replication by affecting related signaling pathways,thus playing a positive role in reversing the progression of RVE.However,at present,there are few studies on the regulation of autophagy by TCM in the treatment of RVE,and no systematic elaboration is available.This review aimed to summarize the role of autophagy in the pathogenesis of RVE and its intervention with TCM,in order to provide more theoretical and clinical evidence for the treatment of RVE with TCM.