细胞焦亡在肝纤维化中的作用及中医药调控研究进展

Research progress on the role of pyroptosis in liver fibrosis and its regulation by traditional Chinese medicine

肝纤维化(HF)是肝损伤后的重要病理修复过程,阻断HF发展是阻止其向肝硬化、肝癌或肝衰竭转变的重要环节,目前尚缺乏理想的治疗HF的特效药物。细胞焦亡是一种新型的程序性细胞死亡方式,以细胞膜上孔隙形成和促白细胞介素(IL)-18、IL-1β生成释放为表现。在肝脏受到持续损伤时肝星状细胞、肝巨噬细胞和肝细胞均会发生细胞焦亡,进而持续激活炎症反应,导致肝脏结构被破坏,最终引起HF。中医药在抗HF过程中具有多靶点、多途径等优势,中药及其活性成分、中药药对及中药复方均可通过抑制细胞焦亡而发挥抗HF的作用,以中医药调节细胞焦亡作为切入点可能是未来治疗HF的新方向。该文总结了细胞焦亡的分子机制、肝脏各个类型细胞发生焦亡与HF的关系,以及中药及其活性成分、中药药对及中药复方通过抑制肝脏细胞发生焦亡进而阻止HF进程的相关研究,以期为进一步的临床研究及试验提供参考依据。

Hepatic fibrosis(HF)is an important pathological repair process after liver injury,and blocking the development of HF is an important link to prevent its transformation into cirrhosis,liver cancer or liver failure.Currently,there is no ideal specific drug for the treatment of HF.Pyroptosis is a new type of programmed cell death,which is characterized by pore formation on the cell membrane and the production and release of interleukin(IL)-18 and IL-1β.When the liver is continuously damaged,pyroptosis will occur in hepatic stellate cells,hepatic macrophages and hepatocytes,which will continue to activate the inflammatory response,leading to the destruction of liver structure and ultimately cause HF.Traditional Chinese medicine(TCM)has the advantages of multi-target and multi-pathway in the process of anti-fibrosis.TCM and its active ingredients,TCM pair and TCM compound can play an anti-HF role by inhibiting pyroptosis.The regulation of pyroptosis by TCM may be a new direction for the treatment of HF in the future.This article summarizes the molecular mechanism of pyroptosis,the relationship between pyroptosis of various types of liver cells and HF,and the related research on Chinese medicine and its active ingredients,Chinese medicine pair and Chinese medicine compound to prevent the process of HF by inhibiting pyroptosis of liver cells,in order to provide reference for further clinical research and experiments.