中医药干预慢性阻塞性肺疾病相关信号通路的研究进展

Traditional Chinese Medicine Intervention of Signaling Pathways in Chronic Obstructive Pulmonary Disease:A Review

慢性阻塞性肺疾病(COPD)是一种气流受限不完全可逆的异质性疾病,呈进行性发展。其反复发作,难以根治的特性为患者带来了沉重的健康负担。COPD发病机制繁杂,尚未完全阐明。当前临床多采用西医药物治疗方式,疗效不理想,易出现不良反应和耐药性等。因此,寻找一种高效、安全的治疗方法是现今医学研究领域的重要课题。随着对疾病研究的不断深入,诸多学者发现,中医药通过靶向核转录因子-κB(NF-κB)、磷脂酰肌醇3-激酶/蛋白激酶B(PI3K/Akt)、丝裂原活化蛋白激酶(MAPK)、神经源性位点缺口同源蛋白(Notch)、Janus酪氨酸激酶(JAK)/信号转导与转录激活因子(STAT)、转化生长因子-β(TGF-β)/Smad、分泌型糖蛋白(Wnt)、河马(Hippo)和核因子E2相关因子2(Nrf2)等信号通路,影响气道黏液分泌,抑制炎症及氧化应激反应,缓解气道重塑及微血管重塑,调节细胞凋亡与自噬等,从而达到减轻疾病症状,改善肺功能的目的。中医对于本病已有数千年的临床实践经验,且疗效显著。因此从细胞分子层面深入挖掘,为临床应用中医药诊治COPD提供可靠的理论依据。但目前中医药调控COPD相关信号通路的系统性总结较少,现对近年来国内外中药单体或中药复方干预COPD相关文献进行广泛检索查阅,整理归纳出多条相关通路,旨在为之后的临床组方用药与实验研究提供新的思路予以借鉴。将中医基础理论和现代药理研究机制相结合共同推动中医药在防治COPD方面的蓬勃发展。

Chronic obstructive pulmonary disease(COPD)is a heterogeneous disease characterized by incompletely reversible airflow limitation that progresses over time.Its recurrent and incurable nature imposes a significant health burden on patients.The pathogenesis of COPD is complex and has not been fully elucidated.Currently,Western medicine is commonly used in clinical treatment,which often yield suboptimal results and may lead to adverse reactions and drug resistance.Therefore,finding an effective and safe treatment method is a crucial focus in medical research.With the ongoing advancement in disease research,many scholars have discovered that traditional Chinese medicine(TCM)can target various signaling pathways such as nuclear factorkappa B(NF-κB),phosphatidylinositol 3-kinase/protein kinase B(PI3K/Akt),mitogen-activated protein kinase(MAPK),neurogenic locus notch homolog protein(Notch),Janus kinase(JAK)/signal transducer and activator of transcription(STAT),transforming growth factor-β(TGF-β)/Smad,secreted glycoprotein(Wnt),Hippo,and nuclear factor erythroid 2-related factor 2(Nrf2).By influencing these pathways,TCM can affect airway mucus secretion,inhibit inflammation and oxidative stress,alleviate airway and microvascular remodeling,and regulate apoptosis and autophagy,ultimately reducing disease symptoms and improving lung function.TCM has thousands of years of clinical practice experience in treating COPD,demonstrating significant efficacy.Therefore,delving deeply into this from a cellular and molecular perspective can provide a reliable theoretical basis for the clinical application of TCM in treating COPD.However,systematic summaries of how TCM regulates COPD-related signaling pathways are scarce.This article aimed to extensively review and summarize recent literature in China and abroad on interventions of TCM monomers or compound prescriptions in COPD,identifying multiple related pathways to provide new insights for future clinical formulation and experimental research.Integrating basic TCM theories with modern pharmacological research mechanisms can jointly propel the development of TCM in the prevention and treatment of COPD.