糖尿病周围神经病变细胞凋亡机制及中医药干预研究进展

Cell Apoptosis Mechanism and Traditional Chinese Medicine Intervention in Diabetic Peripheral Neuropathy:A Review

糖尿病周围神经病变是糖尿病最常见的并发症之一,其发病率高,是糖尿病患者致残、致畸、致死的主要原因。目前糖尿病周围神经病变的发病机制尚未阐述清楚,可能与氧化应激、炎症反应、微循环功能障碍、代谢异常等相关。近年研究发现,周围神经细胞凋亡在糖尿病周围神经病变的发病机制中具有重要作用。目前常见的细胞凋亡途径有线粒体通路、死亡受体通路和内质网通路,三者共同调控机体的细胞凋亡过程。中医药在糖尿病周围神经病变的治疗中疗效明确,具有整体调节、多靶点、多途径的治疗优势。研究表明,中药活性成分及复方可通过调控周围神经细胞凋亡信号通路达到改善糖尿病周围神经病变的效果。随着研究的深入,细胞凋亡途径可能成为继氧化应激后抗糖尿病周围神经病变新药研究的又一潜在靶点。因此,本文即以细胞凋亡为切入点,结合三条细胞凋亡途径相关的信号通路,综述了近年来中药干预糖尿病周围神经病变的研究进展,为糖尿病周围神经病变的临床防治及新药研发提供参考。

Diabetic peripheral neuropathy is a common complication of diabetes,and its pathogenesis is complex. Its high morbidity can result in disability,teratogenesis,and death in diabetic patients. At present,the pathogenesis of diabetic peripheral neuropathy has not been clearly elucidated,which may be related to oxidative stress,inflammatory response,microcirculation dysfunction,metabolic abnormalities,etc. Recent studies have found that apoptosis plays an important role in the pathogenesis of diabetic peripheral neuropathy. The three pathways,i. e.,mitochondrial pathway,death receptor pathway,and endoplasmic reticulum pathway,jointly regulate the cell apoptosis in the body. Traditional Chinese medicine,with definite efficacies in the treatment of diabetic peripheral neuropathy, is advantageous in overall regulation and multi-target and multi-pathway treatment. As reported,the active ingredients in Chinese medicine and Chinese medicinal compounds can alleviate diabetic peripheral neuropathy by regulating apoptosis signaling pathways. Furthermore,apoptosis pathways are expected to be potential targets for new drugs against diabetic peripheral neuropathy following oxidative stress. Therefore,this paper,taking apoptosis as the entry point,reviewed the research progress on TCM intervention in diabetic peripheral neuropathy in recent years to provide references for the clinical prevention and treatment of diabetic peripheral neuropathy and the development of new drugs.