刺五加防治神经退行性疾病的药理研究进展

Research progress of Acanthopanax senticosus in prevention and treatment of neurodegenerative diseases

神经退行性疾病是严重影响人类生活质量的全球性公共卫生难题,其发病率逐年上升且尚无有效的治疗手段。刺五加为传统补肾中药,药用及食用历史悠久,含有多种活性成分如皂苷类、香豆素类、黄酮类、有机酸类和多糖类等,具有抗氧化、抗衰老、抗炎、抗疲劳及免疫调节等多种药理作用。现代医学研究发现刺五加可以作用于中枢神经系统,刺五加的提取物及多种活性成分能改善学习和记忆能力,具有抗氧化、抗炎、抗细胞凋亡、拮抗Aβ毒性、调节神经递质含量、调控多种信号通路、维持线粒体的结构和功能、调节脑内能量代谢、表观遗传调控等重要作用,对神经退行性疾病的治疗具有多成分、多靶点、多通路、低毒副作用的特点。该文综合了刺五加近十年来在神经退行性疾病如阿尔茨海默病、帕金森病以及缺血性脑卒中的国内外药理研究报道,对刺五加发挥神经保护作用的活性成分、作用机制进行总结,并从中医理论及现代医学研究等方面探讨了刺五加治疗神经退行性疾病的显著优势和研究的不足之处,以期为刺五加在神经退行性疾病的药物开发及临床应用提供理论支持,也为中医补肾法防治神经退行性疾病提供参考。

Neurodegenerative diseases are global public health problems that seriously affect the quality of human life. The incidence of neurodegenerative diseases is increasing year by year and there has been no effective treatment. Acanthopanax senticosus is a Chinese medicine for tonifying kidney and has a long medicinal and edible history. It contains many active ingredients such as saponins, coumarins, flavonoids, organic acids and polysaccharides, with pharmacological effects of anti-oxidation, anti-age, anti-inflammation, anti-fatigue and immune regulation. Modern medical studies have found that A. senticosus can act on the central nervous system, and its extracts and active ingredients can improve learning and memory ability, playing vital roles of anti-oxidation, anti-inflammation, anti-apoptosis, antagonizing against amyloid β protein(Aβ) toxicity, modulating neurotransmitter release, signaling pathways and brain energy metabolism, maintaining the structure and function of mitochondria, and epigenetic regulation. It treats neurodegenerative diseases via multiple components, multiple targets, and multiple pathways, with the characteristics of low toxic side effects. This study reviewed the pharmacological reports of A. senticosus on neurodegenerative diseases such as Alzheimer′s disease, Parkinson′s disease and ischemic stroke in China and abroad in recent ten years, and summarized the active ingredients and the mechanism underlying the neuroprotective effects of A. senticosus. Additionally, the significant advantages of A. senticosus in the treatment of neurodegenerative diseases and the limitations of the reports were discussed from the aspects of traditional Chinese medicine(TCM) theory and modern medical research. This study provided theoretical support for the drug development and clinical application of A. senticosus in treating neurodegenerative diseases and also facilitated the prevention and treatment of neurodegenerative diseases by kidney-tonifying method in TCM.