摘要
糖尿病肾病(DN)是糖尿病患者的慢性微血管并发症,也是终末期肾病(ESRD)的主要原因。研究表明核转录因子-κB(NF-κB)通过激活炎症、氧化应激、纤维化、凋亡、自噬、焦亡等病理机制参与了DN的病理进程。因此,阻断NF-κB信号通路的转导有助于防治DN。目前,西医治疗包括降糖、降压、降脂等策略,以及使用内皮素受体拮抗剂、盐皮质激素受体拮抗剂、醛固酮合酶抑制剂等药物,但仍无法阻断DN的病理进程。中医药具有标本兼治、简便价廉等优势,近年来其在干预DN进程中取得了显著进展,其中NF-κB作为关键因子在中药防治DN中发挥了重要作用。该文总结了近五年来中药基于NF-κB信号通路治疗DN的研究成果,阐述了多种中药提取物,如多糖类、萜类、酚类、黄酮类、皂苷类和生物碱类,以及中药复方如槐杞黄颗粒、黄芪三七复方、丹蛭降糖胶囊等,通过调控NF-κB信号通路及其上下游因子,阻断DN的病理进程,从而抑制DN引起的肾脏病理损伤并减缓肾功能恶化,旨在为研发防治DN的药物提供新的思路和参考依据。
Diabetic nephropathy(DN)is a chronic microvascular complication in diabetic patients and the main cause of end-stage renal disease(ESRD).Studies have shown that nuclear factor kappa-B(NF-κB)signaling pathway is involved in the pathological process of DN by activating pathological mechanisms such as inflammation,oxidative stress,fibrosis,apoptosis,autophagy,and pyroptosis.Therefore,blocking the transduction of NF-κB signaling pathway can help prevent and treat DN.Currently,western medical treatment involves strategies such as lowering blood sugar,blood pressure,and lipids,as well as using endothelin receptor antagonists,mineralocorticoid receptor antagonists,aldosterone synthase inhibitors,and other drugs,but they still cannot block the pathological process of DN.Traditional Chinese medicine(TCM)offers a simpler and more cost-effective approach that addresses both the symptoms and underlying causes of DN.Recent research has shown promising results in managing DN with TCM,and NF-κB,as a key factor,plays an important role in the prevention and treatment of DN.This article summarized the research results of TCM based on the NF-κB signaling pathway for the treatment of DN in the past five years.It described a variety of TCM extracts,such as polysaccharides,terpenes,phenols,flavonoids,saponins,and alkaloids,as well as TCM compound prescriptions such as Huaiqihuang granules,Astragalus mongholicus Bunge and Panax notoginseng formula,and Danzhi Jiangtang capsules,which regulated the NF-κB signaling pathway and its upstream and downstream factors to block the pathological process of DN.This inhibition aims to prevent renal pathological damage caused by DN and slow down the deterioration of renal function.The article aims to provide new ideas and references for the research and development of drugs for the prevention and treatment of DN.
作者
郭江凡
王晓萌
张秋娥
李晓晨
刘铜华
吴丽丽
秦灵灵
李青松
GUO Jiangfan;WANG Xiaomeng;ZHANG Qiu'e;LI Xiaochen;LIU Tonghua;WU Lili;QIN Lingling;LI Qingsong(First Clinical College of Shaanxi University of Chinese Medicine,Xianyang 712046,China;Key Laboratory of Health Cultivation of the Ministry of Education,Beijing University of Chinese Medicine,Beijing 100029,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2024年第20期241-251,共11页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家自然科学基金青年基金项目(82004338)
中医养生学教育部重点实验室建设项目(2024-JYB-KYPT-002)。
关键词
中药
糖尿病肾病
核转录因子-κB(NF-κB)
信号通路
病理机制
traditional Chinese medicine
diabetic nephropathy
nuclear factor kappa-B(NF-κB)
signaling pathway
pathological mechanisms
