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1.甘肃省中医院,兰州 730050
2.甘肃省妇幼保健院,兰州 730050
3.甘肃中医药大学,兰州 730030
Received:02 November 2021,
Published Online:24 March 2022,
Published:05 October 2022
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李建省,王英明,闫燕顺等.自噬在肾间质纤维化中的作用及中药干预研究进展[J].中国实验方剂学杂志,2022,28(19):274-282.
LI Jiansheng,WANG Yingming,YAN Yanshun,et al.Role of Autophagy in Renal Interstitial Fibrosis and Intervention of Chinese Medicine: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(19):274-282.
李建省,王英明,闫燕顺等.自噬在肾间质纤维化中的作用及中药干预研究进展[J].中国实验方剂学杂志,2022,28(19):274-282. DOI: 10.13422/j.cnki.syfjx.20221991.
LI Jiansheng,WANG Yingming,YAN Yanshun,et al.Role of Autophagy in Renal Interstitial Fibrosis and Intervention of Chinese Medicine: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(19):274-282. DOI: 10.13422/j.cnki.syfjx.20221991.
肾间质纤维化(RIF)是慢性肾脏疾病进展至肾功能衰竭的共同通路,其发病机制主要与肾脏炎症损伤、氧化应激、细胞凋亡、细胞外基质(ECM)的过度沉积等相关,转化生长因子-
β
1
(TGF-
β
1
)信号通路、哺乳动物雷帕霉素靶蛋白(mTOR)信号通路等多种信号通路介导了RIF的发生发展。因其发生机制复杂,临床上尚无特异性防治措施。自噬是真核细胞产生的非损伤性应答,通过降解和重吸收作用,参与维持组织内稳态的平衡。目前,中医药在治疗慢性肾脏疾病延缓RIF的进程中以其多成分、多效应、多靶点的的独特优势取得了较好的临床疗效。学者研究发现自噬与中医阴阳学说、癥瘕积聚理论等在一定程度上相符合,并且自噬参与了RIF的诸多环节,RIF病程进展与自噬关系密切,通过干预自噬靶向治疗RIF已成为研究的前沿方向。然而,有关自噬在RIF中的作用及中医药调控自噬治疗RIF的研究相对比较少,因此,有必要进一步阐述自噬与RIF的关系,以明确自噬在RIF中发挥的作用机制及中医药调控自噬靶向治疗RIF的机制,该文就中医理论与自噬和RIF的相关性,结合自噬在RIF中炎症损伤、氧化应激、细胞凋亡、ECM过度沉积等的作用,自噬与TGF-
β
1
信号通路、mTOR信号通路在RIF的调控机制,对自噬在RIF中的作用及中药干预的研究进行疏理和总结,以期为RIF的治疗及新药研发提供参考依据。
Renal interstitial fibrosis(RIF)is a common pathway for the progression of chronic kidney disease to renal failure,and its pathogenesis is mainly related to renal inflammatory damage,oxidative stress,apoptosis,and excessive extracellular matrix(ECM) deposition. Transforming growth factor-
β
1
(TGF-
β
1
) signaling pathway,mammalian target of rapamycin(mTOR) signaling pathway and other signaling pathways mediate the occurrence and development of RIF. Because of the complicated mechanism of RIF,there have been no specific prevention and treatment measures in clinical practice. Autophagy is a non-damaging response produced by eukaryotic cells. It maintains the balance of tissue homeostasis through degradation and reabsorption. At present, Chinese medicine has achieved desirable clinical effects with its unique advantages of multiple components,multiple effects,and multiple targets in the treatment of chronic kidney disease to delay the process of RIF. Scholars have found that autophagy is consistent with the Yin-Yang theory and the theory of abdominal mass in traditional Chinese medicine (TCM) to a certain extent,and it is involved in many aspects of RIF. The progression of RIF is closely related to autophagy. The targeted therapy of RIF by intervention in autophagy has become the frontier of research. However,little is known about the role of autophagy in RIF and the regulation of autophagy by Chinese medicine in the treatment of RIF. Therefore,it is necessary to further elucidate the relationship between autophagy and RIF in order to clarify the mechanism of autophagy in RIF and the mechanism of Chinese medicine regulating autophagy in targeted therapy of RIF. This article focused on the correlation between autophagy and RIF based on TCM theory,and systematically summarized the role of autophagy in RIF and the intervention of Chinese medicine by combining the effects of autophagy on inflammation damage,oxidative stress,apoptosis,and excessive ECM deposition in RIF, and the regulation mechanism of autophagy in TGF-
β
1
and mTOR signaling pathways in RIF. This study was expected to provide a certain reference for the clinical treatment of RIF and the development of new drugs.
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