TGF-β/Smads信号通路在心力衰竭心肌纤维化中的作用及中医药干预研究现状

Role of TGF-β/Smads signaling pathway in myocardial fibrosis of heart failure and research status of traditional Chinese medicine intervention

在心力衰竭(HF)进展过程中,转化生长因子-β(TGF-β)/Smads信号通路的异常转导是HF心肌纤维化(MF)的重要机制。TGF-β是MF的关键因子,在HF MF过程中处于过度表达状态。Smads是TGF-β下游的主要效应因子,TGF-β/Smads通路诱导肌成纤维细胞异常增殖,加重心肌细胞外基质沉积,使心脏组织抗纤维化能力减弱,在HF MF的发病机制中发挥复杂作用。中医药在防治HF MF方面具有明确抑制心肌胶原沉积、抗心肌纤维化、保护心肌和改善心脏功能等功效。TGF-β/Smads通路是中药单体、中药复方、中成药发挥HF心肌保护作用的关键通路之一。本文对近10年来中医药干预TGF-β/Smads通路治疗HF MF现有的实验研究成果进行综述,以期为HF MF的防治及新药开发提供理论依据。

During the progression of heart failure(HF),abnormal transduction of the transforming growth factor-β(TGF-β)/Smads signaling pathway is important mechanism of myocardial fibrosis(MF) in HF.TGF-β,a key factor in MF,is in an overexpression state in the process of MF in HF,and Smads is a major effector downstream of TGF-β.The TGF-β/Smads pathway induces abnormal proliferation of myofibroblasts,aggravates myocardial extracellular matrix deposition,and reduces the ability of the cardiac tissues to resist fibrosis,which plays a complex role in the pathogenesis of MF in HF.Traditional Chinese medicine(TCM) has the efficacy of unequivocal inhibiting myocardial collagen deposition,anti-MF,protecting the myocardium and improving cardiac function in the prevention and treatment of MF in HF and so on,and the TGF-β/Smads pathway is one of the key pathways through which TCM monomers,TCM combinations,and proprietary medicines can exert their cardioprotective effects on the HF.This paper reviews the existing experimental research results of TCM intervening in the TGF-β/Smads pathway for the treatment of MF in HF over the past 10 years,with a view to providing theoretical basis for the prevention and treatment of HF MF well as the development and of new drugs.