中西医调控线粒体自噬防治脑缺血再灌注损伤的研究进展

Research progress on the regulation of mitophagy by traditional Chinese and Western medicine to prevent cerebral ischemia-reperfusion injury

脑缺血再灌注损伤(cerebral ischemia-reperfusion injury,CIRI)是缺血性脑卒中后的脑组织血流发生再灌注,而加重其损伤的一种现象。线粒体自噬是一种选择性自噬,通过特异性自噬消除受损或功能失调的线粒体,防止产生过多的活性氧(reactive oxygen species,ROS)以及随后的细胞死亡过程。近年来,线粒体作为疾病治疗的研究热点已广泛用于CIRI的临床治疗中,线粒体自噬与CIRI的相关探索也因此引发研究热潮。最新研究表明,线粒体自噬在脑缺血中的保护作用主要与其在CIRI中的神经保护作用有关,线粒体自噬在CIRI导致的神经细胞内线粒体结构及功能损伤的调控中扮演重要角色。同时,一些调控线粒体自噬途径的干预方法,如中医药(包括中药复方、中药有效成分、针灸等)、西医(西药、运动、基因等)受到有关学者广泛关注,中西医调控线粒体自噬已成为临床治疗CIRI的有效干预措施。因此,本文作者阐述了近年来有关线粒体自噬在CIRI中发挥作用的机制以及中西医靶向线粒体自噬防治CIRI的研究概况,以期为中西医治疗缺血性脑卒中的临床研究提供理论依据。

Cerebral ischemia-reperfusion injury(CIRI) is a phenomenon that aggravates the damage caused by reperfusion of cerebral blood flow after ischemic stroke.Mitophagy is a selective autophagy that eliminates damaged or dysfunctional mitochondria through specific autophagy,preventing excessive production of reactive oxygen species(ROS) and the subsequent process of cell death.In recent years,mitochondria have been widely used in the clinical treatment of CIRI as a research hotspot for disease treatment,and the related exploration of mitophagy and CIRI has also triggered a research upsurge.The latest research shows that the protective effect of mitophagy in cerebral ischemia is mainly related to its neuroprotective effect in CIRI,and mitophagy plays an important role in the regulation of mitochondrial structure and function damage in nerve cells caused by CIRI.At the same time,some intervention methods to regulate the mitophagy pathway,such as traditional Chinese medicine(including traditional Chinese medicine,active ingredients of traditional Chinese medicine,acupuncture,etc.),and western medicine(western medicine,exercise,genes,etc.) have received extensive attention from relevant scholars and become an effective intervention in the clinical treatment of CIRI.Therefore,this paper systematically expounds the mechanism of the role of mitophagy in CIRI in recent years and the research overview of Chinese and Western medicine targeting mitophagy in the prevention and treatment of CIRI,in order to provide a theoretical basis for the clinical research of Chinese and Western medicine in the treatment of ischemic stroke in accordance with.