基于调控巨噬细胞探讨中医药通过改善炎症微环境促糖尿病溃疡愈合的机制

Discussion on the Mechanism of Traditional Chinese Medicine Promoting Diabetes Ulcer Healing by Improving Inflammatory Microenvironment Based on Regulating Macrophages

糖尿病创面患者常伴随周围血管病变及周围神经病变,溃疡创面长期处于高糖及缺血微环境,导致创面局部呈现持续慢性炎症反应状态、迁延不愈伴随巨噬细胞M1/M2极化失衡。基于现有证据,从巨噬细胞功能切入,系统综述多种中药复方、中药单体及其核心活性成分促糖尿病创面愈合的潜在机制后指出,常见中药活性成分及复方如姜黄素、丹参酮Ⅱ、金盏花苷E、八宝丹、生脉饮等,均可通过NF-κB、Notch等多种信号通路调节巨噬细胞极化状态、改善糖尿病性周围血管病变、减少巨噬细胞浸润、调控炎症微环境,来改善代谢异常的慢性炎症创面。因此充分利用中药针对巨噬细胞的调控机制作为糖尿病创面患者炎症状态的新型治疗靶点,有望改善患者预后并为相关科研设计及中药新药研发提供新思路。

Diabetic wound patients are often accompanied by peripheral vascular disease and peripheral neuropathy,and ulcer wounds are in a hyperglycemic and ischemic microenvironment for a long time,resulting in persistent and chronic local inflammatory response,prolonged and unhealed,accompanied by the imbalance of macrophage M1/M2 polarization.Based on the existing evidence,this article systematically reviewed the potential mechanisms of various Chinese herbal compounds,monomers and their core active ingredients to promote diabetes wound healing from the perspective of macrophage function.Common Chinese herbal active ingredients and compounds such as curcumin,tanshinone II,marigold glycoside E,Babaodan(八宝丹),Shengmaiyin(生脉饮),etc.can regulate the polarization of macrophages,improve diabetes related peripheral vascular disease,reduce macrophage infiltration,and regulate the inflammatory microenvironment through various signal pathways such as NF-kB,Notch,to improve the chronic inflammatory wound with metabolic abnormalities.Therefore,making full use of the regulation mechanism of traditional Chinese medicine against macrophages as a new therapeutic target for the inflammatory state of diabetes wound patients is expected to improve the prognosis of patients and provide new ideas for related scientific research design and new drug research and development of traditional Chinese medicine.