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1.成都中医药大学 附属医院,成都 610032
2.代谢性疾病中医药调控四川省重点实验室,成都 610031
3.四川省第二中医医院,成都 610014
4.成都中医药大学 基础医学院,成都 611137
袁久术,在读硕士,从事中医药防治糖尿病与代谢病研究,E-mail:1280112697@qq.com
高泓,博士,主任医师、博士研究生导师,从事中医药防治糖尿病与代谢病研究,E-mail:cdgh76@163.com
收稿日期:2023-01-12,
网络出版日期:2023-05-10,
纸质出版日期:2023-07-05
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袁久术,周阳明,王雪茹等.中医药通过PI3K/Akt信号通路防治糖尿病周围神经病变的研究进展[J].中国实验方剂学杂志,2023,29(13):203-212.
YUAN Jiushu,ZHOU Yangming,WANG Xueru,et al.Prevention and Treatment of Diabetic Peripheral Neuropathy by Chinese Medicine Through PI3K/Akt Signaling Pathway: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(13):203-212.
袁久术,周阳明,王雪茹等.中医药通过PI3K/Akt信号通路防治糖尿病周围神经病变的研究进展[J].中国实验方剂学杂志,2023,29(13):203-212. DOI: 10.13422/j.cnki.syfjx.20232195.
YUAN Jiushu,ZHOU Yangming,WANG Xueru,et al.Prevention and Treatment of Diabetic Peripheral Neuropathy by Chinese Medicine Through PI3K/Akt Signaling Pathway: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(13):203-212. DOI: 10.13422/j.cnki.syfjx.20232195.
糖尿病周围神经病变(DPN)起病隐匿,极易漏诊误诊,病变后期可演变成糖尿病足溃疡、坏疽、截肢等严重后果。DPN以轴突变性坏死、神经纤维节段性脱髓鞘、雪旺细胞凋亡等神经细胞损伤为主要病理特点。磷脂酰肌醇3-激酶(PI3K)/蛋白激酶B(Akt)信号通路是一条沟通细胞内外信息传递的经典通路,能够调控细胞增殖、分化、凋亡、自噬、迁移等生物学活动,广泛影响着与DPN相关的多种细胞。近年来,大量研究发现,持续的高糖环境下PI3K/Akt信号通路异常,通过参与DPN的糖脂代谢、氧化应激、炎症反应、自噬、凋亡、血管生成等发病机制,从而加速DPN发生发展。因此,调控PI3K/Akt信号通路,对于DPN的治疗尤为关键。目前临床上尚缺乏有效来延缓或逆转DPN的措施。中医药在防治DPN的进程中以多靶点、多效应、多成分等独特优势取得了较好的临床效果,大量中医药治疗DPN的动物及临床研究均显示PI3K/Akt信号通路是中医药治疗DPN的重要靶点,调控PI3K/Akt信号通路可以促进髓鞘修复再生、延缓神经细胞死亡进程,起到防治DPN的作用。但目前国内外还未见该领域系统的回顾和总结,基于此,该文对PI3K/Akt信号通路的调控及其在DPN发病过程中的作用,以及单味中药或复方有效成分对PI3K/Akt信号通路干预作用进行总结,为DPN的中医药临床诊疗,基础研究及药物开发提供参考。
Diabetic peripheral neuropathy (DPN) is characterized by insidious onset, easy misdiagnosis, and progression to severe consequences such as diabetic foot ulcers, gangrene, and amputation. The main pathological features of DPN are nerve cell injuries, such as axonal degeneration and necrosis, segmental demyelination of nerve fibers, and apoptosis of Schwann cells. The phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway is a classical pathway that communicates intracellular and extracellular information and regulates biological activities such as cell proliferation, differentiation, apoptosis, autophagy, and migration. It widely affects various cells related to DPN. In recent years, numerous studies have found that the sustained high glucose environment causes abnormalities in the PI3K/Akt signaling pathway. This, in turn, accelerates the occurrence and development of DPN by participating in the pathogenesis of DPN, such as glucose and lipid metabolism, oxidative stress, inflammation, autophagy, apoptosis, and angiogenesis. Therefore, regulating the PI3K/Akt signaling pathway is crucial for the treatment of DPN. Currently, there is a lack of effective measures to slow down or reverse DPN in clinical practice. Traditional Chinese medicine (TCM) has unique advantages in preventing and treating DPN with multiple targets, effects, and components. A large number of animal and clinical studies of TCM treatment of DPN have shown that the PI3K/Akt signaling pathway is an important target for TCM treatment of DPN. Regulating the PI3K/Akt signaling pathway can promote myelin sheath repair and regeneration, delay the process of nerve cell death, and play a role in preventing and treating DPN. However, there is currently no systematic review and summary of this field in China and abroad. Therefore, this article summarized the regulation of the PI3K/Akt signaling pathway and its role in the pathogenesis of DPN, as well as the intervention of effective components of single Chinese medicine or compounds on the PI3K/Akt signaling pathway. This study is expected to provide a reference for the clinical diagnosis and treatment of DPN with TCM, basic research, and drug development.
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