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Role of p38 MAPK Pathway in Diabetic Peripheral Neuropathy and Chinese Medicine Intervention： A Review
增强出版- Chinese Journal of Experimental Traditional Medical Formulae Vol. 29, Issue 9, Pages: 99-108(2023)
- 作者机构：
1.陕西中医药大学 第一临床医学院，陕西 咸阳 712046
2.北京中医药大学 教育部中医养生学重点实验室， 北京 100029
3.北京中医药大学 东直门医院， 北京 100700
4.成都中医药大学， 成都 610075
- 作者简介：
- 基金信息：
DOI：10.13422/j.cnki.syfjx.20230725
CLC： R2-0;R22;R242;R2-031;R285.5Published：05 May 2023，
Published Online：31 January 2023，
Received：23 October 2022，
- 稿件说明：
扫 描 看 全 文
杨鹏,张程斐,张亚奇等.p38 MAPK通路在糖尿病周围神经病变中的作用及中药干预的研究进展[J].中国实验方剂学杂志,2023,29(09):99-108.
YANG Peng,ZHANG Chengfei,ZHANG Yaqi,et al.Role of p38 MAPK Pathway in Diabetic Peripheral Neuropathy and Chinese Medicine Intervention： A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(09):99-108.
杨鹏,张程斐,张亚奇等.p38 MAPK通路在糖尿病周围神经病变中的作用及中药干预的研究进展[J].中国实验方剂学杂志,2023,29(09):99-108. DOI： 10.13422/j.cnki.syfjx.20230725.
YANG Peng,ZHANG Chengfei,ZHANG Yaqi,et al.Role of p38 MAPK Pathway in Diabetic Peripheral Neuropathy and Chinese Medicine Intervention： A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(09):99-108. DOI： 10.13422/j.cnki.syfjx.20230725.
摘要
糖尿病周围神经病变（DPN）是指糖尿病患者在排除其他原因后发生的周围神经功能障碍的症状和/或体征，DPN是糖尿病最常见的并发症之一，后期可导致残疾、足部溃疡、截肢等。其发病机制与高糖诱导的神经组织的炎症损伤、氧化应激、线粒体障碍，细胞凋亡关系密切。p38丝裂原活化蛋白激酶（p38 MAPK）信号通路是介导DPN神经组织炎症因子、氧化因子、凋亡因子表达等关键机制，高糖等因子激活p38 MAPK的磷酸化驱动诱发的炎症反应、氧化应激损伤和细胞凋亡，引起细胞脂质过氧化、蛋白质修饰、核酸受损，导致轴突变性和脱髓鞘改变。目前西医药治疗DPN存在明显不良反应、成瘾倾向等不足。近年来中医药在DPN的防治中的研究逐渐增多，中药干预p38 MAPK通路转导改善DPN的探索也取得了一定进展。该文搜集国内外近10年来关于p38 MAPK通路与胰岛素抵抗和周围神经病变的关系、其在DPN病理进程中参与炎症调节、氧化应激、多元醇途径调控、雪旺细胞凋亡等分子生物学机制进行归纳梳理总结；也对中药单体、中成药及中药复方基于p38 MAPK通路抑制DPN周围神经炎症反应、氧化损伤、细胞凋亡反应等途径，抗神经轴突变性和脱髓鞘改变，改善感觉神经和运动神经异常，减轻外周疼痛敏化，促进神经传导机制的相关文献进行整理，以期为临床防治DPN新药的开发提供参考和方向。
Abstract
Diabetic peripheral neuropathy （DPN） is a symptom and/or sign of peripheral nerve dysfunction that occurs in patients with diabetes mellitus when other causes are excluded. DPN， one of the most common complications of diabetes mellitus， can lead to disability， foot ulcers， and amputation at a later stage. Its pathogenesis is closely related to high glucose-induced inflammatory damage， oxidative stress， mitochondrial disorders， and apoptosis in neural tissues. The p38 mitogen-activated protein kinase （p38 MAPK） signaling pathway is a key mechanism mediating the expression of inflammatory factors， oxidative factors， and apoptotic factors of neural tissues in DPN. The inflammatory response， oxidative stress damage， and apoptosis， induced by the activation of p38 MAPK phosphorylation by factors such as high glucose， can cause cell lipid peroxidation， protein modification， and nucleic acid damage， which results in axonal degeneration and demyelination changes. The current treatment of DPN with western medicine has obvious shortcomings such as adverse effects and addictive tendencies. In recent years， the research on traditional Chinese medicine （TCM） in the prevention and treatment of DPN has gradually increased， and the exploration of Chinese medicine intervention in the p38 MAPK pathway transduction to improve DPN has advanced. The present study reviewed the relations of the p38 MAPK pathway with insulin resistance and peripheral neuropathy and summarized the molecular biological mechanisms involved in the pathological process of DPN， such as inflammation regulation， oxidative stress， polyol pathway regulation， and Schwann cell apoptosis in the past 10 years. In addition， the literature on Chinese medicine monomers， Chinese patent medicines， and Chinese medicine compounds in inhibiting inflammatory reactions， oxidative injury， and apoptosis of DPN peripheral nerves based on the p38 MAPK pathway， resisting axonal degeneration and demyelination changes， improving sensory and motor abnormalities， relieving peripheral pain sensitization， and facilitating nerve conduction mechanism to provide references for the development of new drugs for clinical prevention and treatment of DPN.
关键词
糖尿病周围神经病变炎症氧化应激细胞凋亡p38丝裂原活化蛋白激酶（p38 MAPK）中药机制研究进展
Keywords
diabetic peripheral neuropathyinflammationoxidative stressapoptosisp38 mitogen-activated protein kinase （p38 MAPK）Chinese medicinemechanismresearch progress
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