基于TLR4信号通路的中医药干预溃疡性结肠炎研究进展

Traditional Chinese Medicine Intervention in Ulcerative Colitis Based on TLR4 Signaling Pathway:A Review

溃疡性结肠炎(UC)是一种累及结直肠黏膜及黏膜下层的病变,以肠道黏膜炎症为特征。UC发病率呈逐年上升趋势,病情复杂多变,迁延难愈,严重影响患者的身心健康。该病病理机制复杂,其中肠道免疫应答及不可控性炎症反应是其重要的病理生理机制之一。Toll样受体4(TLR4)作为一种跨膜信号转导受体,可介导免疫应答和炎症反应,在UC发生发展中发挥关键作用。目前,UC的治疗主要使用水杨酸剂、糖皮质激素等减轻肠道炎症,虽然可在一定程度上遏制病情的进展,但不良反应较大,停药后又易复发。中医学可以多途径、多效应、多靶点调控TLR4通路,抑制炎症反应,有效干预UC的进展,已逐渐成为防治UC的热点。大量研究表明,中医药治疗UC具有独特优势,其可通过调控TLR4信号通路,加强免疫防御、抑制炎症反应,从而促进肠道黏膜愈合及维持肠道微生物生态系统平衡,有效治疗UC,并取得了一定的研究进展,但目前仍缺乏对中医药调控TLR4信号通路治疗UC全面的综述。故该文通过检索查阅近年来的相关文献,对TLR4信号通路与UC的关系及中医药在其中的作用进行系统性总结,以期为UC的潜在治疗及新药开发提供新的思路。

Ulcerative colitis(UC)is a disease that affects the mucosal and submucosal layers of the colon and is characterized by inflammation of the intestinal mucosa.The incidence of UC is increasing year by year,and it is complex and refractory,severely impacting the physical and mental health of patients.The pathological mechanism of this disease is complex,with immune responses and uncontrollable inflammatory reactions in the intestine being important physiopathologic mechanisms.Toll-like receptor 4(TLR4),as a transmembrane signaling receptor,plays a key role in mediating immune responses and inflammatory reactions in the development of UC.Currently,the treatment of UC mainly relies on salicylic acids,glucocorticoids,and other agents to reduce intestinal inflammation.While these drugs can partially inhibit the progression of the disease,they often come with significant adverse effects and the potential for relapse upon discontinuation.Traditional Chinese medicine(TCM)offers multiple pathways,effects,and targets for regulating the TLR4 pathway,suppressing inflammatory responses,and effectively intervening in the progression of UC.This approach has become a hot topic in the prevention and treatment of UC.Numerous studies have shown that TCM treatment of UC has unique advantages.TCM can enhance immune defenses,suppress inflammatory responses,promote intestinal mucosal healing,and maintain the balance of the intestinal microbiota by regulating the TLR4 signaling pathway,thereby effectively treating UC,with substantial progress achieved.However,there is currently a lack of comprehensive reviews on the role of TCM in regulating the TLR4 signaling pathway for the treatment of UC.Therefore,this article systematically summarized the relationship between the TLR4 signaling pathway and UC,as well as the role of TCM in this context,by reviewing relevant literature from recent years,aiming to provide new insights into the potential treatment and new drug development for UC.