红景天苷对脑缺血损伤的保护作用及机制研究进展

Research Progress on Protective Effect and Mechanism of Salidroside on Cerebral Ischemia Injury:A Review

缺血性脑卒中是由多种因素引起脑内动脉狭窄或阻塞,可导致大脑出现缺血、缺氧、神经元坏死和神经功能障碍等病理损伤,具有高发病率、高致残率、高死亡率的致病特点。脑缺血再灌注损伤是其主要的继发性损伤,严重时可导致患者永久性残疾甚至死亡。中医药治疗脑缺血损伤临床疗效显著,随着中医药现代化发展,中药活性成分的提取及应用日益受到重视。红景天苷作为珍稀中药材红景天的主要活性成分,已被临床前试验证明可通过抑制细胞凋亡、抗氧化应激、减轻炎症反应、保护血脑屏障、调节自噬、促进神经重塑及突触再生等多种途径对抗脑缺血损伤。但因其多途径、多通路、多靶点的作用特点,红景天苷改善脑缺血损伤的具体机制尚未完全阐明。笔者通过梳理近十年相关文献,对红景天苷治疗缺血性脑损伤的作用机制予以综述,同时整理了其药代动力学研究及安全性评价的最近进展,以期为中药活性成分的新药研发及临床应用提供理论依据和新的研究思路。

Ischemic stroke is caused by a variety of factors caused by intracerebral artery stenosis or obstruction,can lead to cerebral ischemia,hypoxia,neuronal necrosis and neurological dysfunction and other pathological injuries,with high morbidity,high disability rate,high mortality characteristics.Cerebral ischemia-reperfusion injury is the main secondary injury,which can lead to permanent disability or even death in severe cases.With the development of traditional Chinese medicine(TCM)modernization,the extraction and application of active components of TCM have been paid more and more attention.Salidroside,as the main active component of Rhodirosea,a rare Chinese medicinal herb,has been proved to fight cerebral ischemia injury by inhibiting cell apoptosis,anti-oxidative stress,reducing inflammatory response,protecting blood-brain barrier,regulating autophagy,promoting nerve remodeling and synaptic regeneration in preclinical trials.However,due to its multi-pathway,multi-pathway and multi-target action characteristics,the specific mechanism of salidroside to improve cerebral ischemia injury has not been fully elucidated.By reviewing relevant literature in the past decade,the author reviewed the mechanism of action of salidroside in the treatment of ischemic brain injury,and summarized the recent progress of its pharmacokinetic studies and safety evaluation,in order to provide theoretical basis and new research ideas for the development and clinical application of the active ingredients of traditional Chinese medicine.