基于巨噬细胞极化探讨中医药治疗肝纤维化的研究进展

Research progress on traditional Chinese medicine in the treatment of liver fibrosis based on macrophage polarization

肝纤维化是一种慢性肝病,其发生和发展与肝脏细胞外基质的沉积及分布异常有关。这种异常反应是肝脏对慢性损伤的一种病理性修复,也是各种慢性肝病发展为肝硬化的关键步骤。巨噬细胞作为一种在脊椎动物体内参与非特异性防卫的吞噬细胞,依照其不同来源(骨髓来源巨噬细胞、腹膜巨噬细胞和脾脏巨噬细胞等)和表型(主要为M1、M2型)可对肝纤维化产生影响。中药单体等成分对巨噬细胞极化的不同通路进行干预,可一定程度延缓肝纤维化的进展,如JNK、PI3K/Akt、Notch、JAK/STAT及NF-κB信号通路等均参与巨噬细胞极化的调控。本文综述中药复方、中药单体等干预巨噬细胞极化过程以治疗肝纤维化的研究进展,为相关研究及临床治疗提供参考。

Liver fibrosis is a chronic liver disease,and its occurrence and development are related to abnormal deposition and distribution of extracellular matrix in liver cells.This abnormal reaction is a pathological repair of liver to chronic injury,and is also a key step in the development of various chronic liver diseases into cirrhosis.Macrophages,as a type of phagocytic cell involved in non-specific defense in vertebrates,can affect liver fibrosis based on their different sources(bone marrow-derived macrophages,peritoneal macrophages and splenic macrophages,etc.)and phenotypes(mainly M1 and M2 types).Interventions of traditional Chinese medicine monomers and other components on different pathways of macrophage polarization can delay the progression of liver fibrosis to a certain extent.For example,JNK,PI3K/Akt,Notch,JAK/STAT,and NF-κB signaling pathway are involved in the regulation of macrophage polarization.This article reviews research progress on the intervention of traditional Chinese medicine formulas and monomers in the polarization process of macrophages to treat liver fibrosis,providing reference for related research and clinical treatment.