中药调控炎症信号通路抗痛风性关节炎的研究进展

Traditional Chinese Medicine Against Gouty Arthritis via Regulating Inflammatory Signaling Pathway:A Review

痛风性关节炎(GA)是人体内嘌呤代谢紊乱和(或)尿酸排泄异常引起的一组代谢性疾病。其发病原因多与饮食结构、蛋白质、糖、脂肪过多摄入有关。临床表现为关节红肿热痛,严重影响患者日常生活,因此对抗GA药物的研究较为迫切。西药治疗GA的药物如秋水仙碱等,虽能在短期内缓解疼痛,但是长期使用不良反应明显;与西药相比,中医药治疗GA疗效确切,安全性强,更易被患者接受。现代医学研究认炎症因子参与、抗氧化应激、细胞凋亡、肠道菌群失调等与GA的发病机制密切相关。经深入研究发现,单味中药及其复方可以调控Toll样受体/髓样分化因子88(TLRs/MyD88)信号通路、NOD样受体蛋白3(NLRP3)炎症小体、核转录因子-κB(NF-κB)等炎症信号通路,进一步干预下游的白细胞介素-1β(IL-1β)、白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、过氧化物酶体增殖物激活受体γ(PPARγ)、NF-κB抑制蛋白-α(IκB-α)、胱天蛋白酶-1(Caspase-1)等细胞因子的表达,减少炎性因子水平,增加抗炎因子水平等发挥水平,从而发挥抗GA的作用。故对近年来中药及其复方调控炎症信号通路介导的炎症反应实验进行总结阐述,为寻找更多相关抗炎中药治疗GA提供新的思路和理论依据。

Gouty arthritis(GA)is a metabolic disease caused by disorders of purine metabolism and/or abnormal excretion of uric acid in the body. Its pathogenesis is mostly related to dietary structure as well as excessive intake of protein,sugar and fat,and the clinical manifestations are joint redness,swelling,heat and pain,which seriously affect the daily life of patients. Therefore,it is urgent to carry out research on anti-GA drugs. Western drugs for the treatment of GA,such as colchicine,can relieve pain in the short term,but with obvious side effects in long-term treatment. Traditional Chinese medicine has definite efficacy and high safety in the treatment of GA and is more acceptable to patients than western medicine. Modern medical research has concluded that inflammatory factors,oxidative stress,apoptosis and intestinal dysbacteriosis are closely related to the pathogenesis of GA. In-depth research has found that single traditional Chinese medicine and its compounds can regulate Toll-like receptors/myeloid differentiation factor 88(TLRs/MyD88)signaling pathway,NLR family pyrin domain containing 3(NLRP3)inflammasome,nuclear transcription factor-κB(NF-κB)and other inflammatory signaling pathways,and further intervene in the downstream cytokines such as interleukin-1β(IL-1β),interleukin-2(IL-2),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),peroxisome proliferatoractivated receptor γ(PPARγ),nuclear factor of kappa light polypeptide gene enhancer in B-cells inhibitor-α(IκB-α)and aspartate-specific cysteine protease 1(Caspase-1)to reduce inflammatory factors and increase antiinflammatory factors,thereby exerting the anti-GA role. Therefore,this paper summarized and elaborated the experiments of inflammatory response mediated by traditional Chinese medicines and their compounds via regulating inflammatory signaling pathways in recent years,which provides new ideas and theoretical basis for finding more related anti-inflammatory traditional Chinese medicines for the treatment of GA.