基于PI3K/Akt、NF-κB信号通路探讨中医药防治心肌缺血再灌注损伤的机制

Mechanism of Traditional Chinese Medicine in Preventing and Treating Myocardial Ischemia-Reperfusion Injury Based on the PI3K/Akt,NF-κB Signaling Pathway

急性心肌梗死(AMI)是一种严重的心血管疾病,其可导致冠状动脉闭塞,造成患者长期缺血、缺氧,从而损伤心功能。目前,再灌注是AMI患者的首选治疗方法,但部分患者缺血心肌恢复血流后会发生心肌缺血再灌注损伤(MIRI),这会严重妨碍患者的治疗效果和预后。因此,如何预防MIRI已成为AMI患者再灌注治疗过程中亟待解决的问题。本文通过回顾既往相关文献发现,PI3K/Akt、NF-κB信号通路可通过调节氧化应激、钙超载、炎症反应、心肌细胞凋亡及铁死亡等而参与MIRI的发生发展。而中医药具有多成分、多途径、多靶点、价格低、不良反应少的优势,可为MIRI的防治提供新思路。基于此,本文从PI3K/Akt、NF-κB信号通路角度出发,探讨中药单体及其有效成分、中药复方及制剂防治MIRI的机制,以期为临床采用中医药防治MIRI提供理论支持。

Acute myocardial infarction(AMI)is a serious cardiovascular disease,which can lead to coronary artery occlusion,long-term ischemia,hypoxia,and thereby impair heart function.Currently,reperfusion is the preferred treatment for patients with AMI.However,myocardial ischemia-reperfusion injury(MIRI)may occur in some patients after the ischemic myocardium restores blood flow,which can seriously hinder the therapeutic effect and prognosis of patients.Therefore,how to prevent MIRI has become an urgent problem to be solved during the reperfusion therapy of AMI patients.This article reviews previous relevant literature and finds that the PI3K/Akt and NF-κB signaling pathways are involved in the occurrence and development of MIRI by regulating oxidative stress,calcium overload,inflammatory response,cardiomyocyte apoptosis and iron death.While traditional Chinese medicine has the advantages of multi-component,multi-pathway,multi-target,low price and few adverse reactions,which can provide a new idea for the prevention and treatment of MIRI.Based on this,from the perspective of PI3K/Akt and NF-κB signaling pathways,the mechanism of TCM monomer and its effective components,TCM compounds and preparations for the prevention and treatment of MIRI was discussed in this paper,in order to provide theoretical support for the clinical use of TCM for the prevention and treatment of MIRI.