针刺对脑缺血再灌注损伤相关信号通路调控作用的研究进展

Research Progress of Acupuncture on Cerebral Ischemia-Reperfusion Injury-Related Signaling Pathways

针刺可调控多条脑缺血再灌注损伤(cerebral ischemia-reperfusion injury,CIRI)相关信号通路,有效改善神经功能障碍,发挥脑保护作用。针刺调控CIRI的作用机制较为复杂,其中,与CIRI炎症反应相关的信号通路有核因子κB(nuclear factor of kappa B,NF-κB)、miR-223/NLRP3等,针刺可通过调节Cezanne蛋白、锌指蛋白A20、IRAK、TAX1BP1等的表达发挥抗炎效应;与CIRI细胞凋亡相关信号通路有丝裂原活化蛋白激酶(mitogen-activated protein kinase,MAPK)、Wnt/β-catenin、JAK/STAT等,针刺通过介导Bax、Bcl-2等凋亡相关基因或PTEN、Akt等蛋白分子水平实现抗脑细胞凋亡功能;与神经血管再生相关信号通路有Notch、CREB、Wnt/β-catenin等,针刺通过促进血管内皮生长因子(vascular endothelial growth factor,VEGF)表达及神经干细胞(neural stem cells,NSC)增殖等促神经发生。此外,miRNA可通过介导炎症信号通路或与细胞分化、增殖相关的Notch信号通路等参与调控CIRI,已成为生物学领域的热点研究。但目前针刺在调控Nrf2/HO-1信号通路介导的氧化应激以及PINK1/Parkin信号通路介导的线粒体损伤等方面的研究较为欠缺,今后应重视相关通路的研究以探讨针刺防治CIRI更深层的机制。同时,进一步挖掘眼针与常规针刺之间所产生效应的差异;将针刺与其他物理疗法联合应用以追求更佳的疗效;进一步规范针刺的操作手法、干预时间等,以优化治疗方案。

Acupuncture can regulate multiple signaling pathways related to cerebral ischemia-reperfusion injury(CIRI),effectively improve neurological dysfunction,and play a role in brain protection.The mechanism of acupuncture regulating CIRI is complex,and the signaling pathways related to the inflammatory response of CIRI include nuclear factor of kappa B(NF-κB),miR-223/NLRP3,etc.Acupuncture exerts anti-inflammatory effect by regulating the expression of Cezanne protein,zinc finger protein A20,IRAK,TAX1BP1,etc.The signaling pathways related to CIRI apoptosis include mitogen-activated protein kinase(MAPK),Wnt/β-catenin,JAK/STAT,etc.Acupuncture achieves anti-apoptotic function of brain cells by mediating apoptosis-related genes such as Bax and Bcl-2 or protein molecules such as PTEN and Akt.Signal pathways related to neurovascular regeneration include Notch,CREB,Wnt/β-catenin,etc.Acupuncture promotes neurogenesis by promoting the expression of vascular endothelial growth factor(VEGF)and the proliferation of neural stem cells(NSC).In addition,miRNAs can participate in the regulation of CIRI by mediating inflammatory signaling pathways or the Notch signaling pathway related to cell differentiation and proliferation,which has become hot research in the field of biology.However,the current research on acupuncture in regulating oxidative stress mediated by Nrf2/HO-1 signaling pathway and mitochondrial damage mediated by PINK1/Parkin signaling pathway is lacking.In the future,attention should be paid to the study of related pathways to explore the deeper mechanism of acupuncture prevention and treatment of CIRI.At the same time,future research urgently needs to further explore the differences in the effects between eye-acupuncture and conventional acupuncture.Combine acupuncture with other physical therapy to pursue better curative effect and further standardize acupuncture manipulation techniques and intervention time to optimize acupuncture treatment plan.