铁死亡在动脉粥样硬化中的作用及中医药干预研究进展

Effect of Ferroptosis on Atherosclerosis and Chinese Medicine Intervention:A Review

动脉粥样硬化(As)是脂质沉积于血管壁引起的一种慢性血管疾病,以脂质代谢紊乱、氧化应激和炎症为主要特征,为冠心病、心力衰竭和中风等心脑血管疾病的病理基础。铁死亡是一种新型调节性细胞死亡方式,其本质为铁依赖性脂质过氧化物累积引起的细胞死亡,在形态学、生物化学和遗传学方面与其他类型的细胞死亡不同。铁死亡发病机制复杂,其机制主要与谷胱甘肽/谷胱甘肽过氧化酶4抗氧化系统活性、铁代谢、铁自噬、脂质过氧化程度等多个途径有关。铁死亡在As过程中起着重要作用,参与As血管内皮细胞损伤、巨噬细胞炎症、泡沫细胞形成及血管平滑肌细胞增殖迁移等多个病理过程,已成为As研究的新靶点。中医药是我国独有且富有价值的医学科学,具有深厚的理论沉淀和实践积累。研究表明中药复方、中药单体及活性成分可调控血管相关细胞铁死亡,对As的防治具有独特优势。该文主要对铁死亡在As各病理环节中的作用及相关中医药干预进行综述,旨在从铁死亡角度为中医药防治As提供新方向。

Atherosclerosis(As)is a chronic vascular disease caused by lipid deposition on the vascular wall and is characterized by lipid metabolism disorder,oxidative stress,and inflammation.It is the pathological basis of cardiovascular and cerebrovascular diseases such as coronary heart disease,heart failure,and stroke.Ferroptosis is a new type of cell death caused by iron-dependent lipid peroxidation,which is morphologically,biologically,and genetically distinct from other types of cell death.The pathogenesis of ferroptosis is complex and is mainly related to the activity of the glutathione/glutathione peroxidase 4 antioxidant system,iron metabolism,iron autophagy,lipid peroxidation,and other pathways.Ferroptosis plays an important role in the process of As and is involved in many pathological processes such as vascular endothelial cell injury,macrophage inflammation,foam cell formation,and vascular smooth muscle cell proliferation and migration.It has become a new target for As research.Traditional Chinese medicine(TCM)is a unique and valuable medical science in China,with profound theoretical and practical accumulation.Studies have shown that Chinese medicine compounds,Chinese medicine monomers,and active ingredients can regulate ferroptosis in vascular-related cells and have unique advantages in the prevention and treatment of As.This article mainly reviewed the role of ferroptosis in various pathological links of As and related Chinese medicine intervention,aiming to provide a new direction for the prevention and treatment of As by Chinese medicine from the perspective of ferroptosis.