生物节律调控缺血性中风及中医药的干预作用

Regulation of ischemic stroke by circadian rhythm and intervention by traditional Chinese medicine

生物节律是生物体为适应自然界环境的昼夜周期变化而形成的内在调控机制,调节哺乳动物的病理生理过程、疾病发生发展及对治疗的反应性。生物节律可显著影响缺血性中风的易感性、损伤、恢复和对治疗的反应机制。越来越多的证据表明,生物节律不仅对缺血性中风事件的重要生理因素,如血压、凝血-纤溶系统具有调控作用,同时还参与缺血损伤后由胶质细胞、外周免疫细胞介导的免疫炎症反应,以及对神经血管单元(neurovascular unit,NVU)的调节作用。该研究旨在将生物节律生物学中的分子、细胞和生理途径与缺血性中风的临床后果联系起来,阐述生物节律对缺血性中风发病的影响,对神经血管单元的调控,对免疫炎症反应的调节,并综述中药干预生物节律的研究进展,为后续生物节律的中医药研究和分子机制研究提供合理的、有价值的参考依据。

Circadian rhythm is an internal regulatory mechanism formed in organisms in response to the circadian periodicity in the environment, which modulates the pathophysiological events, occurrence and development of diseases, and the response to treatment in mammals. It significantly influences the susceptibility, injury, and recovery of ischemic stroke, and the response to therapy. Accumulating evidence indicates that circadian rhythms not only regulate the important physiological factors of ischemic stroke events, such as blood pressure and coagulation-fibrinolysis system, but also participate in the immuno-inflammatory reaction mediated by glial cells and peripheral immune cells after ischemic injury and the regulation of neurovascular unit(NVU). This article aims to link molecular, cellular, and physiological pathways in circadian biology to the clinical consequences of ischemic stroke and to illustrate the impact of circadian rhythms on ischemic stroke pathogenesis, the regulation of NVU, and the immuno-inflammatory responses. The regulation of circadian rhythm by traditional Chinese medicine is reviewed, and the research progress of traditional Chinese medicine intervention in circadian rhythm is summarized to provide a reasonable and valuable reference for the follow-up traditional Chinese medicine research and molecular mechanism research of circadian rhythm.