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Role of Autophagy-apoptosis Balance in Colorectal Cancer and Traditional Chinese Medicine Intervention： A Review
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 29, Issue 23, Pages: 207-217(2023)
- 作者机构：
1.广西中医药大学 研究生学院，南宁 530001
2.广西中医药大学 第一附属医院，南宁 530001
- 作者简介：
- 基金信息：
DOI：10.13422/j.cnki.syfjx.20231592
CLC： R2-0;R22;R2-031;R574.62;R735Published：05 December 2023，
Published Online：10 February 2023，
Received：30 October 2022，
- 稿件说明：
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徐明瑶,谢胜,黎丽群等.自噬-凋亡平衡调控在结直肠癌中的作用及中药干预研究进展[J].中国实验方剂学杂志,2023,29(23):207-217.
XU Mingyao,XIE Sheng,LI Liqun,et al.Role of Autophagy-apoptosis Balance in Colorectal Cancer and Traditional Chinese Medicine Intervention： A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(23):207-217.
徐明瑶,谢胜,黎丽群等.自噬-凋亡平衡调控在结直肠癌中的作用及中药干预研究进展[J].中国实验方剂学杂志,2023,29(23):207-217. DOI： 10.13422/j.cnki.syfjx.20231592.
XU Mingyao,XIE Sheng,LI Liqun,et al.Role of Autophagy-apoptosis Balance in Colorectal Cancer and Traditional Chinese Medicine Intervention： A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(23):207-217. DOI： 10.13422/j.cnki.syfjx.20231592.
摘要
结直肠癌（CRC）是起源于结直肠黏膜上皮的消化系统恶性肿瘤，在进展到晚期之前通常是一种无症状的疾病。该病全球发病率居高不下，且呈年轻化趋势，严重威胁患者的健康与生命安全。该病病理机制尚未完全明确，与细胞自噬、凋亡和炎症反应等相关。自噬和凋亡同属于细胞程序性死亡，存在着复杂的交互调控，二者失衡与诸多疾病的发生、发展及预后密切相关。细胞自噬-凋亡失衡是CRC主要的病理基础，在CRC发病中起关键作用。一方面，自噬与凋亡互相协同，共同抑制CRC细胞生长；另一方面，自噬可以拮抗凋亡而促进CRC细胞生长。目前，临床治疗CRC的手段以手术联合放疗、化疗的综合治疗方案为主，可以在一定程度上控制CRC的进展，但不良反应较大、远期效果不佳。近年来，中医药在治疗CRC上取得了一定成效，发现众多中药单体可以通过调控自噬-凋亡平衡，促进CRC细胞死亡，从而阻断该病的进展。基于自噬-凋亡平衡调控细胞生命的进程，发现其蕴含着中医阴阳理论的变化规律，具有相似的理论内涵。中医药调控自噬-凋亡平衡参与CRC的各个阶段，已成为研究的前沿方向，但目前尚缺乏全面系统的阐述。基于此，该文总结了近年来的相关研究进行系统综述，主要介绍了中医阴阳理论与自噬-凋亡平衡的相关性，自噬-凋亡平衡在CRC的作用，黄酮类、萜类、苷类、酚类等不同类型的27个中药单体成分调控自噬-凋亡平衡治疗CRC的研究现状，发现中药单体通过调控自噬-凋亡平衡治疗CRC涉及微管相关蛋白1轻链3（LC3）、Beclin-1、B细胞淋巴瘤-2（Bcl-2）等分子靶点，蛋白激酶B（Akt）/哺乳动物雷帕霉素靶蛋白（mTOR）、活性氧（ROS）/c-Jun氨基末端激酶（JNK）等多条信号通路，起到平衡阴阳的作用，以期为CRC的治疗及新药研发提供一定的参考及思路。
Abstract
Colorectal cancer （CRC）， a malignant tumor of the digestive system， originates from the colorectal mucosa epithelium and is usually asymptomatic until it progresses to an advanced stage. With high incidence around the globe and the increasingly younger patients， this disease poses a serious threat to the health and lives of the patients. Although the pathogenesis of this disease is not fully understood， it is generally believed that it is associated with autophagy， apoptosis， and inflammation. Autophagy and apoptosis as two types of programmed cell death are subject to complex interactive regulation， and the imbalance between them is closely related to the occurrence， development， and prognosis of a variety of diseases. Studies have shown that autophagy-apoptosis balance plays a key role in CRC. On the one hand， autophagy and apoptosis coordinate with each other to inhibit CRC cell growth. On the other hand， autophagy can antagonize apoptosis to promote CRC cell growth. In clinical practice， surgery is often combined with radiotherapy and chemotherapy to treat CRC， which can control the progression of CRC to a certain extent but has serious adverse effects and poor long-term results. In recent years， traditional Chinese medicine （TCM） has been proved to be effective in the treatment of CRC. Studies have shown that numerous herbal active components can promote CRC cell death by regulating the autophagy-apoptosis balance， thereby blocking the progression of this disease. The process of autophagy-apoptosis balance in regulating cell activities has similar theoretical connotations with the Yin and Yang theory of TCM. Applying TCM in regulating autophagy-apoptosis balance at various stages of CRC has become a frontier， while the comprehensive elaboration remains to be conducted. By reviewing the relevant studies in recent years， this paper introduces the correlation between the Yin and Yang theory and the autophagy-apoptosis balance， the role of autophagy-apoptosis balance in CRC， and the research progress in the application of 27 Chinese herbal active components such as flavonoids， terpenoids， glycosides， and phenols capable of regulating autophagy-apoptosis balance in the treatment of CRC. The active components in Chinese medicines can recover the autophagy-apoptosis balance in CRC by acting on microtuble-associated protein 1 light chain 3（LC3）， Beclin-1， and B-cell lymphoma-2（Bcl-2）to regulate multiple signaling pathways such as protein kinase B（Akt）/mammalian target of rapamycin（mTOR）and reavtive oxygen species（ROS）/ c-Jun N-terminal kinase（JNK）， thus balancing Yin and Yang. This review aims to provide a reference for the treatment of CRC and the development of new drugs.
关键词
结直肠癌（CRC）自噬-凋亡平衡中药单体研究进展
Keywords
colorectal cancer（CRC）autophagy-apoptosis balanceactive components in Chinese medicinesresearch progress
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