中医药调控PI3K/AKT信号通路防治慢性心力衰竭研究状况

Research status in traditional Chinese medicine regulation of PI3K/AKT signaling pathway for prevention and treatment of chronic heart failure

慢性心力衰竭(CHF)是各种心血管疾病的终末期表现,是各种心脏结构或功能疾病所造成的心室充盈和(或)射血分数受损的一组综合征。该病的发病机制复杂多样,大多与细胞凋亡的活性增强有关。磷酸肌醇-3激酶/蛋白激酶B(PI3K/AKT)信号通路参与CHF的发生、发展和病理形成。相关研究表明,PI3K/AKT通路是中药治疗CHF的关键靶通路。本文对近年来中药调控PI3K/AKT通路干预CHF的机制和作用进行分析和总结,发现中药提取物、中成药及中药复方均可改善CHF的心肌细胞损伤,其作用机制与细胞凋亡、炎症因子、氧化应激和心室重构密切相关。同时创造性地总结了PI3K/AKT通路在防治CHF中存在的对立性争议,并分析了产生争议原因,以期为CHF的治疗和新药研发提供新思路。

Chronic heart failure(CHF) is the end-stage manifestation of various cardiovascular diseases, which is a group of syndrome caused by various cardiac structural or functional diseases with impaired ventricular filling and/or ejection fraction. The pathogenesis of this disease is complex and varied, mostly related to the enhancement of apoptosis activity. Phosphoinositol-3 kinase/protein kinase B(PI3K/AKT) signaling pathway is involved in the occurrence, development and pathologic formation of CHF. Relevant studies have shown that PI3K/AKT pathway is a key target pathway for the treatment of CHF with traditional Chinese medicine. In this paper, we analyzed and summarized the mechanism and effects of PI3K/AKT pathway regulated by traditional Chinese medicine in intervening CHF in recent years. It was found that extracts of traditional Chinese medicine, proprietary Chinese medicine and compound Chinese medicine can improve myocardial cell injury in CHF, and the mechanism of action is closely related to apoptosis, inflammatory factors, oxidative stress and ventricular remodeling. At the same time, we creatively summarize the antagonistic controversy of PI3K/AKT signaling pathway in the prevention and treatment of CHF, and analyze the reasons for the controversy, in order to provide new ideas for the treatment of CHF and the development of new drugs.