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1.山东中医药大学,济南 250355
2.山东中医药大学 附属医院,济南 250014
Received:29 October 2020,
Published Online:26 January 2021,
Published:20 September 2021
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张蕾,刘佳丽,蔺琳等.剪切力对动脉粥样硬化的影响及中药抗剪切力损伤的研究进展[J].中国实验方剂学杂志,2021,27(18):234-242.
ZHANG Lei,LIU Jia-li,LIN Lin,et al.Effect of Fluid Sheer Stress on Atherosclerosis and Progress of Research on Treatment of Sheer Stress Injury with Traditional Chinese Medicine: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(18):234-242.
张蕾,刘佳丽,蔺琳等.剪切力对动脉粥样硬化的影响及中药抗剪切力损伤的研究进展[J].中国实验方剂学杂志,2021,27(18):234-242. DOI: 10.13422/j.cnki.syfjx.20210723.
ZHANG Lei,LIU Jia-li,LIN Lin,et al.Effect of Fluid Sheer Stress on Atherosclerosis and Progress of Research on Treatment of Sheer Stress Injury with Traditional Chinese Medicine: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(18):234-242. DOI: 10.13422/j.cnki.syfjx.20210723.
动脉管壁的细胞不断受到因血液流动而产生的剪切力的作用,剪切力在动脉粥样硬化的形成过程中扮演着举足轻重的角色。位于血液和血管壁之间的内皮细胞对血流剪切力有独特的反应,可以将机械刺激转化为细胞内信号,进而影响动脉粥样硬化病理进程。内皮功能不仅受生长因子、激素等生化物质的调控,还受到血流剪切力等机械作用力的影响。在生理状态下,剪切力可通过维持内皮细胞稳态发挥抗动脉粥样硬化作用,病理剪切力则会导致内皮功能障碍,促进动脉粥样硬化进展。在不同的剪切力介导下,可以通过表观遗传学途径或机械敏感性阳离子通道调控内皮功能。因此,有必要了解异常剪切应力如何影响各种信号转导途径以引起内皮功能障碍及动脉粥样硬化。中医药治疗动脉粥样硬化疗效确切,具有不良反应少,多靶点、多重机制发挥作用的特点,因此,越来越得到人们认可。近年来,对流体剪切力介导下中药复方和单味中药提取物抗动脉粥样硬化作用机制的认识也逐步深入。该综述将以内皮功能为切入点,系统梳理剪切力对动脉粥样硬化病理过程的影响及相关分子机制,并通过整理现有文献,首次总结中药抗剪切力损伤的最新研究进展,阐明剪切力与内皮功能、动脉粥样硬化的相互关系及中药的干预效应,以期为动脉粥样硬化的中医临床治疗和病理机制研究提供理论依据。
Cells in the arterial wall are constantly subjected to the shear stress generated by the blood flow. Shear stress plays a pivotal role in the formation of atherosclerosis. The endothelial cells located between the blood and the vessel wall have a unique response to the shear stress of the blood flow, which can convert mechanical stimulation into intracellular signals, thereby affecting the pathological process of atherosclerosis. Endothelial function is not only regulated by hormones, growth factors and other biochemical substances, but also affected by mechanical forces such as blood flow shear stress. Physiologically, shear stress can play an anti-atherosclerotic role in maintaining the homeostasis of endothelial cells. Pathological shear stress will lead to endothelial dysfunction and promote the progression of atherosclerosis. Under the mediation of different shear stress, the endothelial function can be regulated through epigenetic pathways or mechanically sensitive cation channels. Therefore, it is necessary to understand how various signal transduction pathways are affected by pathological shear stress, so as to cause endothelial dysfunction and atherosclerosis. Traditional Chinese medicine(TCM) has been increasingly recognized for its curative effect in treating atherosclerosis, with the advantages of few side effects, multiple targets and multiple mechanisms. In recent years, the understanding of the anti-atherosclerosis mechanism of TCM mediated by shear stress has gradually deepened. This review will take endothelial function as the breakthrough point, systematically sort out the influence of shear stress on the pathological process of atherosclerosis and the related molecular mechanisms. Meanwhile, it is the first time to summarize the latest research progress of Chinese medicine against shear stress damage by sorting out the existing literature. This article mainly clarify the relationship between shear stress, endothelial function, atherosclerosis and TCM, in order to provide a theoretical basis for the clinical treatment and pathological mechanism of atherosclerosis.
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