线粒体自噬在糖尿病及其并发症中的作用与中药干预进展

Role of mitophagy in diabetes mellitus and its complications and traditional Chinese medicine intervention: a review

糖尿病(diabetes mellitus, DM)是一种慢性内分泌疾病,其特征是由于碳水化合物或脂质代谢或胰岛素功能紊乱而引起高血糖症。DM中的高血糖症和长期代谢紊乱会损害全身组织器官,导致严重的并发症。线粒体自噬(mitophagy)是细胞内重要的线粒体质量控制过程,是一种特殊的自噬现象,其中受损或多余的线粒体可被自噬溶酶体选择性清除,对于维持细胞稳态和细胞在压力下的生存至关重要。在既往研究中,自噬的改变已经被证实在DM及其并发症的发展和控制中发挥着重要作用。近年来,线粒体自噬作为研究热点,与多种临床疾病的发病机制密切相关。大量证据表明线粒体自噬在调节DM及其并发症的代谢稳态中亦起到关键作用。由于破坏性的大血管并发症和微血管并发症导致病死率增加、失明、肾衰竭以及DM患者的整体生活质量下降,故亟待开发靶向干预DM及其并发症的治疗策略。中医药具有多成分、多靶点、多层次协同起效的独特优势,可防止耐药性的产生,在防治DM及其并发症方面疗效显著。因此,探讨中药调控线粒体自噬的潜在机制,可能会成为治疗DM及其并发症的新方法。该综述将重点探讨线粒体自噬在DM及其并发症中的功能和潜在机制,并对中药调控线粒体自噬干预DM及其并发症的研究现状进行总结与展望,以期为DM及其并发症的治疗提供新思路。

Diabetes mellitus(DM) is a chronic endocrine disease characterized by hyperglycemia caused by carbohydrate or lipid metabolism disorders or insulin dysfunction. Hyperglycemia and long-term metabolic disorders in DM can damage tissues and organs throughout the body, leading to serious complications. Mitochondrial autophagy(mitophagy) is an important mitochondrial quality control process in cells and a special autophagy phenomenon, in which damaged or redundant mitochondria can be selectively removed by autophagic lysosome, which is crucial to maintain cell stability and survival under stress. Studies have confirmed that changes in autophagy play a role in the development and control of DM and its complications. Mitophagy has become a research hotspot in recent years and it is closely associated with the pathogenesis of a variety of diseases. Substantial evidence suggests that mitophagy plays a crucial role in regulating the metabolic homeostasis in the case of DM and its complications. Because the destructive great vessel complications and microvascular complications cause increased mortality, blindness, renal failure, and declined quality of life of DM patients, it is urgent to develop targeted therapies to intervene in DM and its complications. Traditional Chinese medicine(TCM), with a multi-component, multi-target, and multi-level action manner, can prevent the development of drug resistance and have significant therapeutic effects in the prevention and treatment of DM and its complications. Therefore, exploring the mechanisms of TCM in regulating mito-phagy may become a new method for treating DM and its complications. With focus on the roles and mechanisms of mitophagy in DM and its complications, this paper summarizes and prospects the research on the treatment of DM and its complications with TCM via re-gulating mitophagy, aiming to provide new ideas for the clinical practice.