基于PI3K/Akt通路的中药治疗糖尿病研究进展

Research Progress of Traditional Chinese Medicine in Treating Diabetes Mellitus Based on PI3K/Akt Pathway

糖尿病是一组以高血糖为特征的代谢性疾病,发病率极高,并发症较多,目前已成为世界范围内日益严重的公共健康问题,严重影响人民的生活质量。磷脂酰肌醇3激酶(PI3K)/蛋白激酶B(Akt)信号通路是胰岛素信号转导的主要途径,也是调控血糖的主要信号通道,其信号分子的异常可引起信号转导途径异常,从而影响相应组织器官细胞的增殖、凋亡、转移和侵袭,导致疾病的发生。研究PI3K/Akt信号通道对于考察中药是否具有明确而稳定的降血糖作用具有积极的意义。目前,治疗糖尿病的中药、西药相对较多,但多数药物尤其是西药对于并发症的控制相对较差,为了解中药在治疗糖尿病方面的进展,以期更好地研究中药在糖尿病方面的综合治疗作用及机制,进一步发挥中医药在糖尿病治疗方面的多靶点、多途径、多通道、标本兼治的优势与特色,本文就近年来基于PI3K/Akt信号通路的中药治疗糖尿病体内、外研究进行了较为系统的分析,包括基于该信号通道的对糖尿病产生直接原因的胰岛素分泌的影响、对胰岛素3个主要靶器官(肝、骨骼肌、脂肪)及对糖尿病4个主要并发症相应部位(脑、肾、心、睾丸)的影响,也为研究中药单味药及复方的降血糖机制研究提供一定的思路及指导。

Diabetes mellitus(DM) is a metabolic disease characterized by hyperglycemia,with a high incidence and many complications. It has become an increasingly serious public health problem in the world,and has seriously affected the quality of life. Phosphatidylinositol-3-kinases(PI3 K)/protein kinase B(Akt) signaling pathway is the main pathway of insulin signal transmission and the main signal channel for regulating blood glucose.The abnormal signal molecule of PI3 K/Akt may cause abnormal signal transduction pathway,so as to impact the proliferation,apoptosis,metastasis and invasion of the corresponding tissues and organs,and lead to the occurrence of disease. Study of PI3 K/Akt signal channel has a positive significance for investigating whether traditional Chinese medicine(TCM) has a definite and stable hypoglycemic effect. Currently,there are many TCM and Western medicines to treat diabetes,however,most drugs,especially Western medicines,have a relatively poor effect in controlling complications. To understand the progress of TCM in treatment of diabetes,in expectation of better studying the comprehensive therapeutic effect and mechanism of TCM on diabetes,and further developing the multi-target,multi-way and multi-channel advantages and features of TCM in the treatment of diabetes,this paper focuses on a systematic analysis on the progress of in vivo and in vitro studies on DM based on PI3 K/Akt signaling channel in recent years,including the effect of the signaling channel on insulin secretion,the three main target organs of insulin(liver,skeletal muscle and fat),and its effect on the four main complications of diabetes(brain,kidney,heart,testis),and also provides certain ideas and guidance for the study of hypoglycemic mechanism of TCM monomer,TCM and compound medicine.