TGF-β1/Smad信号通路在肺纤维化中的作用及中医药调控研究进展

Role of TGF-β1/Smad Signaling Pathway in Pulmonary Fibrosis and Traditional Chinese Medicine Regulation:A Review

肺纤维化(Pulmonary fibrosis,PF)是呼吸系统疾病中一类极为复杂难治的疾病,PF患者诊断后生存期极短,死亡率高,故被称为“类肿瘤疾病”,严重危害着人类健康。临床上常用的抗肺纤维化的药物主要有糖皮质激素、吡非尼酮、尼达尼布、N-乙酰半胱氨酸、等,但这些药物皆存在不良反应多、价格昂贵、疗效欠佳等诸多弊端。研究发现PF的病理过程十分复杂,涉及多种机制,但其确切机制尚不明确。因此,阐明其潜在机制,提出安全有效的靶向治疗策略,是目前临床上治疗PF亟待解决的问题。大量研究证实TGF-β1/Smad信号通路在肺纤维化的发展中发挥至关重要的作用。中医药在防治肺纤维化方面具有独特优势和良好前景,其中有不少中药或中药复方可靶向调节TGF-β1/Smad信号通路。本文就TGF-β1/Smad信号传导通路在肺组织纤维化中的调控作用以及近7年来中医药靶向调控TGF-β1/Smad信号传导通路防治肺纤维化研究进展作简要综述,以期为临床中医药防治肺纤维化提供理论支撑。

Pulmonary fibrosis(PF)is a complex and refractory respiratory disease.After diagnosis,PF patients have short survival time and high mortality,and thus PF is called a"tumor-like disease",which seriously endangers human health.The commonly used anti-PF drugs mainly include glucocorticoid,pirfenidone,nintedanib and N-acetylcysteine,but these drugs have many disadvantages such as various adverse reactions,high cost and poor efficacy.It has been found that the pathological process of PF is complicated and involves multiple mechanisms,but the exact mechanism remains unclear.Therefore,elucidating the potential mechanism of PF and proposing safe and effective targeted therapies are urgent problems to be solved in clinical treatment of PF.A large number of studies have confirmed that TGF-β1/Smad signaling pathway plays a crucial role in the development of PF.Traditional Chinese medicine(TCM)has unique advantages and good prospects in the prevention and treatment of PF,among which many single TCMs and their effective ingredients or TCM compounds can regulate TGF-β1/Smad signaling pathway in a targeted way.In this paper,the regulatory role of TGF-β1/Smad signaling pathway in PF and the research progress of TCM prevention and treatment of PF via targeting TGF-β1/Smad signaling pathway in recent 7 years were reviewed,to provide theoretical support for clinical prevention and treatment of PF by TCM.