中医药调控相关信号通路治疗结直肠癌药理机制研究进展

Research progress on pharmacological mechanisms of traditional Chinese medicine regulating related signaling pathways in the treatment of colorectal cancer

结直肠癌的发生发展涉及多条通路的异常改变,其主要有巨大细胞癌症母细胞/β-连接蛋白(Wnt/β-catenin)、丝裂原活化蛋白激酶(mitogen-activated protein kinases,MAPK)、磷脂酰肌醇-3激酶/蛋白激酶B(phosphatidylinositol 3-hydroxy kinase/protein kinase B,PI3K/Akt)、酪氨酸激酶/转录因子(janus kinase/signal transducers and activators of transcription,JAK/STAT)、腺苷酸激活蛋白激酶(AMP-activiated protein kinase,AMPK)及核因子-κB(nuclear factor kappa-B,NF-κB)等。随着中医药事业的快速发展,多项研究证实了中医药可通过调控上述相关通路来有效治疗结直肠癌。中药可通过调控不同通路上的信号分子而发挥不同的作用,其机制大致分为促使结直肠癌细胞凋亡、抑制细胞增殖、促进或抑制细胞自噬、影响细胞生长周期、阻断细胞迁移及侵袭、阻碍细胞新生和血管生成以及增强细胞耐药性。现将中医药治疗结直肠癌所涉及通路与药理机制进行综述,以期为中医药防治结直肠癌研究提供方向,也进一步分析现存在的问题,为后期完善研究方案提供参考。

The occurrence and development of colorectal cancer involve abnormal changes in multiple pathways,mainly involving Wnt/β-catenin,mitogen-activated protein kinases(MAPK)、phosphatidylinositol 3-hydroxy kinase/protein kinase B(PI3K/Akt)、janus kinase/signal transducers and activators of transcription(JAK-STAT)、AMP-activiated protein kinase(AMPK)and nuclear factor kappa-B(NF-κB)pathways.With the rapid development of traditional Chinese medicine,multiple studies have confirmed that traditional Chinese medicine can effectively treat colorectal cancer by regulating the aforementioned pathways.Traditional Chinese medicine can play different roles by regulating signaling molecules on different pathways.Its mechanisms can be roughly divided into promoting colorectal cancer cell apoptosis,inhibiting cell proliferation,promoting or inhibiting cell autophagy,affecting cell growth cycle,blocking cell migration and invasion,hindering cell neovascularization,and enhancing cell resistance.This article reviewed the pathways and pharmacological mechanisms involved in the treatment of colorectal cancer with traditional Chinese medicine,in order to provide references for the research on the prevention and treatment of colorectal cancer with traditional Chinese medicine,and further analyzed the existing problems,providing references for improving the research plan.