基于miRNA探讨中医药疗法从心肌细胞凋亡角度治疗缺血再灌注损伤

Exploration on the Treatment of Ischemia-reperfusion Injury by TCM from the Perspective of Cardiomyocyte Apoptosis Based on miRNA

心肌缺血再灌注损伤(MIRI)是心肌缺血/缺氧复流之后心肌细胞出现不可逆凋亡,尚无特效药物,是亟待解决的临床问题。随着研究深入,发现中医药疗法可靶向调控微小核糖核酸(miRNA)改善心肌细胞凋亡,且有多靶点、高疗效、低毒性等特点。近年来,中医药疗法调控miRNA在体外实验与体内实验中抗心肌细胞凋亡方面均取得一定成果,但尚处于实验阶段,未提出临床相关理论。本文基于miRNA形成及生物学过程、3条经典细胞凋亡途径(外源性、内源性、内质网)阐述miRNA与细胞凋亡的相关性,归纳中成药、中药单体、电针疗法、中药复方调节miRNA-21、miRNA-1、miRNA-499、miRNA-126、miRNA-133抑制心肌细胞凋亡相关研究,认为中医药疗法可通过miRNA调控心肌细胞凋亡治疗MIRI,旨在为中医药疗法治疗MIRI相关研究及临床提供理论参考。

Myocardial ischemia-reperfusion injury(MIRI)is the irreversible apoptosis of myocardial cells after myocardial ischemia/hypoxia reflow,and there is no specific drug,which is urgent to solve the clinical problem.With further research,it has been found that TCM therapy could improve myocardial apoptosis by targeting miRNA regulation,which has the characteristics of multiple targets,high efficacy and low toxicity.In recent years,the regulation of miRNA by TCM therapy has made some achievements in the anti-apoptosis of cardiomyocytes in vitro and in vivo experiments.However,it is still in the experimental stage and no relevant clinical theories have been proposed.Therefore,this article discussed the formation and biological process of miRNA,described the three classical apoptotic pathways of exogenous,endogenous and endoplasmic reticulum,then elaborated the relationship between miRNA and apoptosis,and summarized the research related to the inhibition of cardiomyocytes apoptosis by traditional Chinese patent medicines,TCM monomer,electroacupuncture,and TCM compounds on miRNA-21,miRNA-1,miRNA-499,miRNA-126,and miRNA-133.It suggested that TCM therapy may regulate cardiomyocytes apoptosis through miRNA to treat MIRI,aiming at providing theoretical reference for the research and clinical application of TCM therapy in the treatment of MIRI.