Nrf2/ARE通路在脑缺血再灌注损伤中的作用及中医药干预治疗研究进展

Research Progress of Role of Nrf2/ARE Pathway in Cerebral Ischemia-reperfusion Injury and Traditional Chinese Medicine Intervention

缺血性脑卒中(IS)以脑内动脉血栓栓塞或血栓形成、脑组织缺血缺氧损害为基本特征,其发生发展机制复杂,脑缺血再灌注损伤(CIRI)诱发的氧化应激反应、炎症反应是IS治疗过程中造成神经功能继发性损害的重要病理因素。目前认为,刺激内源性抗氧化系统的表达将会是治疗IS的主要措施。核转录因子红系2相关因子2(Nrf2)/抗氧化反应元件(ARE)信号通路是细胞内维持氧化还原稳态、参与氧自由基清除的重要信号通路,具有抗氧化应激、调节炎症损伤、抗细胞凋亡、缓解钙离子超载等功能,可调控CIRI中的大量关键下游分子。中医药以辨证、整体的观念干预Nrf2/ARE信号通路在CIRI中的作用。

Ischemic stroke(IS)is characterized by cerebral artery thromboembolism/thrombosis and cerebral tissue hypoxic-ischemic damage,which has complex mechanisms.Oxidative stress response and inflammatory response induced by cerebral ischemia-reperfusion injury(CIRI)are important pathological factors in IS treatment,which can cause secondary damage of nerve function.It is commonly believed that stimulating the expression of endogenous antioxidant system will be the useful treatment for IS.Nuclear factor-erythroid 2-related factor 2(Nrf2)/antioxidant response element(ARE)signal pathway is an important pathway that can maintain redox homeostasis and participate in oxygen free radical scavenging,with the functions of anti-oxidative stress,regulating inflammatory injury,anti-apoptosis,alleviating calcium overload and so on,thus can regulate large numbers of key downstream molecules of CIRI.Traditional Chinese medicine can intervene the functions of Nrf2/ARE signal pathway in CIRI by its syndrome differentiation and holistic concept.