Précédent|Prochain

Mécanisme de l'axe « immunité-métabolisme-génétique » dans le traitement de la PVD par la méthode de tonification rénale

  • role： First author第一作者
  • Affiliation：

    Guang'anmen Hospital， China Academy of Chinese Medical Sciences， Beijing 100053，China

  • Email：sunxyjxnl@163.com
  • Introduction：孙璇，在读硕士，从事中西医结合防治心血管疾病研究，E-mail：sunxyjxnl@163.com
SUN Xuan,  
  • role： Corresponding author通信作者
  • Affiliation：

    Guang'anmen Hospital， China Academy of Chinese Medical Sciences， Beijing 100053，China

  • Email：wangjie0103@126.com
  • Introduction：王阶，博士生导师，主任医师，全国名中医，从事中西医结合防治心血管疾病研究，E-mail：wangjie0103@126.com
WANG Jie*,  
  • Affiliation：

    Guang'anmen Hospital， China Academy of Chinese Medical Sciences， Beijing 100053，China

ZHANG Zhenpeng,  
  • Affiliation：

    Guang'anmen Hospital， China Academy of Chinese Medical Sciences， Beijing 100053，China

LIU Lanchun,  
  • Affiliation：

    Guang'anmen Hospital， China Academy of Chinese Medical Sciences， Beijing 100053，China

LIU Yongmei,  
  • Affiliation：

    Guang'anmen Hospital， China Academy of Chinese Medical Sciences， Beijing 100053，China

LIU Chao

résumé

La maladie vasculaire périphérique (PVD) est une pathologie vasculaire systémique et est devenue la principale cause de mortalité chez la population de notre pays. Actuellement, il n'existe pas de traitements systémiques efficaces. La pratique clinique montre que la méthode chinoise de tonification rénale peut efficacement intervenir dans la PVD et agit sur les mécanismes pathologiques clés selon la médecine occidentale. En vue de cela, l'étude se développe selon trois aspects : premièrement, clarifier les mécanismes pathologiques centraux occidentaux de la PVD qui comprennent un déséquilibre immunitaire, des troubles métaboliques et une susceptibilité génétique. Les manifestations pathologiques typiques comprennent des lésions progressives de l'endothélium vasculaire, des dépôts lipidiques et la formation de plaques, conduisant finalement à des lésions multi-organes et des dysfonctionnements. D'une part, l'activation de la voie du complexe inflammatoire NLRP3 déclenche le déséquilibre immunitaire ; d'autre part, elle induit des perturbations du métabolisme énergétique mitochondrial, du métabolisme hydrique et sodé ainsi que du métabolisme hormonal, en synergie avec une susceptibilité génétique telle que le gène de l'apolipoprotéine (APO) E, accélérant le déséquilibre de l'homéostasie vasculaire. Deuxièmement, analyser profondément la relation intrinsèque entre la théorie traditionnelle chinoise de la « déficience rénale » et l'axe « immunité-métabolisme-génétique », révélant la base théorique de l'intervention de la méthode de tonification rénale dans la PVD. Les reins stockent l'essence et contrôlent la production osseuse et médullaire, liées à la génération et différenciation des cellules immunitaires ; les reins régulent la transformation du Qi et contrôlent le métabolisme matériel et énergétique ; les reins sont la source innée et principale de la reproduction, étroitement liés aux mécanismes génétiques. Troisièmement, en s'appuyant sur la recherche clinique moderne, énoncer les avantages uniques et la valeur clinique de la méthode de tonification rénale agissant sur l'axe « immunité-métabolisme-génétique » des organes cibles cœur, cerveau et reins. Les formules traditionnelles et leurs composants actifs améliorent la réponse inflammatoire immunitaire, renforcent l'homéostasie métabolique énergétique et remodelent les voies épigénétiques via plusieurs voies, ciblant ainsi diverses voies pour intervenir dans la PVD. Cette étude explique systématiquement la connotation scientifique de la méthode de tonification rénale pour traiter la PVD, posant une base théorique et un guide pratique pour la prévention et le traitement combinés en médecine chinoise et occidentale, en vue de favoriser l'innovation et l'amélioration des schémas diagnostics et thérapeutiques dans ce domaine.

mots-clés

maladie vasculaire périphérique;immunité-métabolisme-génétique;mécanisme pathologique;m éthode de tonification rénale;traitement en médecine chinoise

References

  1. 1.
    LIU M B，HE X Y，YANG X H，et al.Summary of the report on cardiovascular health and diseases in China 2023（epidemiology of cardiovascular diseases and status of interventional diagnosis and treatment）［J］.Chin J Interv Cardiol，2024，32（10）：541-550.
  2. 2.
    YANG J，ZHANG Y M，GE J B.Screening and early detection of panvascular diseases［J］.Shanghai Med J，2022，45（5）：293-297.
  3. 3.
    LI J，SUN Y N，WANG J.Thinking of traditional Chinese medicine in prevention and treatment of panvascular diseases based on ''blood vessel-Zangfu organ-syndrome differentiation and treatment''［J］.Chin J Exp Tradit Chin Med Form，2024，30（10）：187-195.
  4. 4.
    ACHIM A，PÉTER O Á，COCOI M，et al.Correlation between coronary artery disease with other arterial systems：Similar，albeit separate，underlying pathophysiologic mechanisms［J］.J Cardiovasc Dev Dis，2023，10（5）：210.
  5. 5.
    HERRINGTON W，LACEY B，SHERLIKER P，et al.Epidemiology of atherosclerosis and the potential to reduce the global burden of atherothrombotic disease［J］.Circ Res，2016，118（4）：535-546.
  6. 6.
    NORDESTGAARD B G.Triglyceride-rich lipoproteins and atherosclerotic cardiovascular disease：New insights from epidemiology，genetics，and biology［J］.Circ Res，2016，118（4）：547-563.
  7. 7.
    WANG J，LI J，DONG Y，et al.Connotation and prevention strategies of traditional Chinese medicine for panvascular diseases［J］.Chin J Exp Tradit Chin Med Form，2025，31（7）：1-14.
  8. 8.
    KOBIYAMA K，LEY K.Atherosclerosis［J］.Circ Res，2018，123（10）：1118-1120.
  9. 9.
    MEZIANI F，GANDO S，VINCENT J L.Should all patients with sepsis receive anticoagulation？ Yes［J］.Intensive Care Med，2017，43（3）：452-454.
  10. 10.
    CASTRO R，ADAIR J H，MASTRO A M，et al.VCAM-1-targeted nanoparticles to diagnose，monitor and treat atherosclerosis［J］.Nanomedicine，2024，19（8）：723-735.
  11. 11.
    ZHAO S，ZHANG M X，LIU N，et al.Research progress on targeted regulation of inflammation-related signaling pathways by traditional Chinese medicine for the prevention and treatment of atherosclerosis［J/OL］.Chin J Exp Tradit Chin Med Form，2025，doi：.
  12. 12.
    ROSS R，The pathogenesis of atherosclerosis：A perspective for the 1990s［J］.Nature，1993，362（6423）：801-809.
  13. 13.
    KIM K W，IVANOV S，WILLIAMS J W.Monocyte recruitment ，specification，and function in atherosclerosis［J］.Cells，2021，10（1）：15.
  14. 14.
    CHEN Y H，WU K H，WU H P.Unraveling the complexities of Toll-like receptors：From molecular mechanisms to clinical applications［J］.Int J Mol Sci，2024，25（9）：5037.
  15. 15.
    STEINBERG D，WITZTUM J L.Lipoproteins and atherogenesis，current concepts［J］.JAMA，1990，264（23）：3047-3052.
  16. 16.
    GLASS C K，WITZTUM J L.Atherosclerosis，the road ahead［J］.Cell，2001，104（4）：503-516.
  17. 17.
    JIA Z Q，NALLASAMY P，LIU D M，et al.Luteolin protects against vascular inflammation in mice and TNF-alpha-induced monocyte adhesion to endothelial cells via suppressing IκB-α/NF-κB signaling pathway［J］.J Nutr Biochem，2015，26（3）：293-302.
  18. 18.
    SAZDOVA I，HADZI-PETRUSHEV N，KEREMIDARSKA-MARKOVA M，et al.SIRT-associated attenuation of cellular senescence in vascular wall［J］.Mech Ageing Dev，2024，220：111943.
  19. 19.
    SUBALAKSHMI S，RUSHENDRAN R，VELLAPANDIAN C.Revisiting migraine pathophysiology：From neurons to immune cells through lens of immune regulatory pathways［J］.J Neuroimmune Pharmacol，2025，20（1）：30.
  20. 20.
    KUZNETSOVA T，PRANGE K H M，GLASS C K，et al.Transcriptional and epigenetic regulation of macrophages in atherosclerosis［J］.Nat Rev Cardiol，2020，17（4）：216-228.
  21. 21.
    GREBE A，HOSS F，LATZ E.NLRP3 inflammasome and the IL-1 pathway in atherosclerosis［J］.Circ Res，2018，122（12）：1722-1740.
  22. 22.
    CHISTIAKOV D A，MELNICHENKO A A，MYASOEDOVA V A，et al.Mechanisms of foam cell formation in atherosclerosis［J］.J Mol Med，2017，95（11）：1153-1165.
  23. 23.
    MANTOVANI A，SICA A，SOZZANI S，et al.The chemokine system in diverse forms of macrophage activation and polarization［J］.Trends Immunol，2004，25（12）：677-686.
  24. 24.
    BARRETT T J，DISTEL E，MURPHY A J，et al.Apolipoprotein A-I promotes atherosclerosis regression in diabetic mice by suppressing myelopoiesis and plaque inflammation［J］.Circulation，2019，140（14）：1170-1184.
  25. 25.
    AN J Y，HUANG Y，LI W P.Research progress of coronary microcirculation disorder in coronary atherosclerotic heart disease［J］.J Lanzhou Univ：Med Sci，2018，44（6）：76-81.
  26. 26.
    LU X Y，KWONG J Q，MOLKENTIN J D，et al.Individual cardiac mitochondria undergo rare transient permeability transition pore openings［J］.Circ Res，2016，118（5）：834-841.
  27. 27.
    YANG K L，ZENG L T，GE A Q，et al.The effect of Hedysarum multijugum Maxim.-Chuanxiong Rhizoma compound on ischemic stroke：A research based on network and experimental pharmacology［J］.Oxid Med Cell Longev，2020，2020：6072380.
  28. 28.
    ZHANG L Y，HUANG J Q，ZHANG D L，et al.Targeting reactive oxygen species in atherosclerosis via Chinese herbal medicines［J］.Oxid Med Cell Longev，2022：1852330.
  29. 29.
    ZHU G Y，YU H Y，PENG T，et al.Glycolytic enzyme PGK1 promotes M1 macrophage polarization and induces pyroptosis of acute lung injury via regulation of NLRP3［J］.Respir Res，2024，25（1）：291.
  30. 30.
    BRESLOW J L.Genetics of lipoprotein abnormalities associated with coronary artery disease susceptibility［J］.Annu Rev Genet，2000，34：233-254.
  31. 31.
    SERRANO-POZO A，DAS S，HYMAN B T.ApoE and Alzheimer's disease：Advances in genetics，pathophysiology，and therapeutic approaches［J］.Lancet Neurol，2021，20（1）：68-80.
  32. 32.
    PAGE M M，WATTS G F.PCSK9 in context：A contemporary review of an important biological target for the prevention and treatment of atherosclerotic cardiovascular disease［J］.Diabetes Obes Metab，2024，20（2）：270-282.
  33. 33.
    ZHANG H，HALMOS B，WESTERTERP M.Statins for ACTA2 mutation-driven atherosclerosis？ ［J］.Eur Heart J，2023，44（29）：2727-2729.
  34. 34.
    MIR R，ELFAKI I，JAVID J，et al.Genetic determinants of cardiovascular disease：The endothelial nitric oxide synthase 3（eNOS3），Krüppel-like factor-14（KLF-14），methylenetetrahydrofolate reductase（MTHFR），MiRNAs27a and their association with the predisposition and susceptibility to coronary artery disease［J］.Life（Basel），2022，12（11）：1905.
  35. 35.
    DONG M Y，YOU H J，GOU Q L，et al.Exploration of key genes related to necroptosis affecting the instability of atherosclerotic plaques based on data mining［J］.Pract J Cardiovasc Pulm Cereb Vasc Dis，2025，33（2）：65-71.
  36. 36.
    TANG X M，WANG P W，ZHANG R L，et al.KLF2 regulates neutrophil activation and thrombosis in cardiac hypertrophy and heart failure progression［J］.J Clin Invest，2022，132（3）：e147191.
  37. 37.
    KANG K，XIANG J J，ZHANG X S，et al.N6-methyladenosine modification of KLF2 may contribute to endothelial-to-mesenchymal transition in pulmonary hypertension［J］.Cell Mol Biol Lett，2024，29（1）：69.
  38. 38.
    WANG L P，LI S J，STONE S S，et al.The role of the lncRNA MALAT1 in neuroprotection against hypoxic/ischemic injury［J］.Biomolecules，2022，12（1）：146.
  39. 39.
    BASSAND K，METZINGER L，NAÏM M，et al.miR-126-3p is essential for CXCL12-induced angiogenesis［J］.J Cell Mol Med，2021，25（13）：6032-6045.
  40. 40.
    LI X P，SHEN H S，ZHANG M，et al.Glycolytic reprogramming in macrophages and MSCs during inflammation［J］.Front Immunol，2023，14：1199751.
  41. 41.
    IMHOF B A，AURRAND-LIONS M.Adhesion mechanisms regulating the migration of monocytes［J］.Nat Rev Immunol，2004，4（6）：432-444.
  42. 42.
    LI D N，YANG C H.Discussion on the correlation between hypertension in the elderly treated from the kidney and immunology［J］.J Shandong Univ Tradit Chin Med，2023，47（2）：148-153.
  43. 43.
    LI M X，ZOU J X，CHEN X Z.Study on the correlation between apoptosis of VSMCS and RANTES level in vulnerable atherosclerotic plaques by tonifying kidney，activating blood and dredging collateral method［J］.J Liaoning Univ Tradit Chin Med，2016，18（10）：26-30.
  44. 44.
    XIE X Q，HUANG X J，CHEN M D，et al.Study on the genetic susceptibility of estrogen receptor single nucleotide polymorphism and intrahepatic cholestasis of pregnancy［J］.China Med Herald，2012，9（21）：51-52.
  45. 45.
    YANG G.Clinical and mechanism study of "kidney-heart- vessel" integrated view and Bushen Huoxue formula in regulating ischemic microenvironment for treating coronary heart disease［D］.Beijing：China Academy of Chinese Medical Sciences，2024.
  46. 46.
    LIU C，HUANG M Y，CHEN G，et al.Research progress on TCM syndromes of coronary heart disease［J］.Chin J Inf Tradit Chin Med，2020，27（5）：137-141.
  47. 47.
    HU F，SHEN J F，DENG P，et al.Clinical study of Bushen Qishu Qiangxin granules in treating chronic heart failure with heart - kidney Yang deficiency syndrome and its influence on immune function and microinflammation［J］.Liaoning J Tradit Chin Med，2021，48（7）：86-91.
  48. 48.
    WANG X，ZHANG J，ZHAO M，et al.Effects of Bushen Tongfu formula on intestinal flora and LPS/TLR4/NF-κB pathway in APP/PS1 mice based on "microorganism-gut- brain axis"［J］.Chin Pharmacol Bull，2025，41（1）：171-178.
  49. 49.
    LI S K.Correlation study between blood stasis syndrome of stroke after aging and SIRT1/NF-κB pathway of neurovascular unit［D］.Zhengzhou：Henan University of Chinese Medicine，2023.
  50. 50.
    YANG T，KANG Y Z，WU M H，et al.Effects of Bushen Yisui capsules on activation of retinal Müller and astrocytes in experimental autoimmune encephalomyelitis mice［J］.Chin J Tradit Chin Med，2022，37（7）：4018-4021.
  51. 51.
    YUAN J H，DUAN L X，ZANG X J，et al.Study on the expression of NLRP and Caspase-1 in renal interstitial fibrosis of diabetic nephropathy rats by astragaloside Ⅳ［J］.Chin J Integr Tradit Chin West Nephrol，2022，23（11）：998-1001，1036.
  52. 52.
    GUO J M，FU Y T，SUO D W，et al.Study on Acanthopanax senticosus injection alleviating renal injury in diabetic nephropathy mice by inhibiting TLR4/NF-κB signaling pathway［J］.Tianjin J Tradit Chin Med，2025，42（1）：100-107.
  53. 53.
    MA J J，ZHU C C，HUANG F L，et al.Study on the effect and mechanism of Bushen Kaixuan formula on renal fibrosis in diabetic nephropathy rats［J］.Acta Chin Med Pharm，2024，52（12）：32-37.
  54. 54.
    LI D，Study on total saponins of Panax quinquefolium stem and leaf in alleviating myocardial ischemia/reperfusion injury by regulating mitochondrial function［D］.Beijing：Beijing Univ Tradit Chin Med，2015.
  55. 55.
    LIU L C，LIU C，HU J，et al.Theoretical origin and clinical application of kidney deficiency and blood stasis syndrome of coronary atherosclerotic heart disease［J］.World Chin Med，2024，19（7）：985-990.
  56. 56.
    XU D J，XU H，TONG R X，et al.Effects of tonifying kidney method on myocardial energy metabolism in atherosclerotic model rats after menopause［J］.Chin J Gerontol，2014，34（15）：4281-4283.
  57. 57.
    CHEN Y J，XIANG L H，ZHANG Z G，et al.Study on myocardial injury in ovariectomized rats and protective effect of Erxian decoction［J］.Chin J Pathophysiol，2015，31（10）：1897-1898.
  58. 58.
    WANG M F，GAO W P，YUAN Y，et al.Exploring the scientific connotation of treating Alzheimer's disease from the kidney based on mitochondria-endoplasmic reticulum coupling structure［J］.World Chin Med，2024，19（24）：3855-3859.
  59. 59.
    ZHOU J J，TAN Z H，YANG Z，et al.Jiajian Shuyu pill mediates mitophagy to improve oxidative stress injury and learning and memory ability in APP/PS1 mice［J］.Chin J Exp Tradit Chin Med Form，2022，28（6）：43-53.
  60. 60.
    QUAN Q H.Effects of "kidney - brain mutual assistance" electroacupuncture on PINK1 and PARKIN in Alzheimer's mice［D］.Shenyang：Liaoning University of Chinese Medicine，2019.
  61. 61.
    SHEN Y F，HAO F R，TANG X L，et al.Effect of Bushen Huoxue granules on ferroptosis of neurons in substantia nigra of Parkinson's disease model mice based on autophagy mediated by nuclear receptor coactivator 4［J］.Chin J Tradit Chin Med，2024，39（2）：926-931.
  62. 62.
    DENG P X，XU M.Experimental study on the effects of Psoralea corylifolia on bone turnover and blood lipid metabolism in ovariectomized rats［J］.J New Chin Med，2005（7）：94-96.
  63. 63.
    WANG X M，WANG J H，ZOU Z J，et al.Effects of flavonoids from Cuscuta chinensis on blood lipids and vascular estrogen receptors in ovariectomized female rats［J］.Chin Tradit Pat Med，2008（2）：255-256.
  64. 64.
    LIU J X，ZHANG W P，LIAN Q S.Phytoestrogen - like effects of Cnidium monnieri［J］.Chin J Clin Rehabil，2005（23）：186-189.
  65. 65.
    GAO R R，SHEN Z，LIAN M H，et al.Research progress of Astragalus - Salvia miltiorrhiza in improving renal fibrosis［J］.Chin J Exp Tradit Chin Med Form，2023，29（17）：228-236.
  66. 66.
    WANG J，LIU L C，LIU C，et al.Identification and analysis of differential miRNA-mRNA interactions in coronary heart disease：An experimental screening approach［J］.Front Cardiovasc Med，2023，10：1186297.
  67. 67.
    LIU C.Clinical and mechanism study of Bushen Huoxue formula regulating lncRNA NEAT1/miR-139-5p/Fos axis in treating kidney deficiency and blood stasis syndrome of coronary heart disease［D］.Beijing：China Academy of Chinese Medical Sciences，2022.
  68. 68.
    LI L L，ZHOU Y L，GAO L J，et al.Research progress of tonifying kidney herbs in antidepressant［J］.Tradit Chin Med Res，2020，33（8）：73-77.
  69. 69.
    ZHAO Q，GAO J P，LI W W，et al.Neurotrophic and neurorescue effects of Echinacoside in the subacute MPTP mouse model of Parkinson's disease［J］.Brain Res，2010，1346：224-236.
  70. 70.
    ZHANG S X.Study on the effect and mechanism of Bazhen Bushen capsule in preventing and treating brain aging- regulating intestinal function under the guidance of Qi- Collateral theory and essence - Qi - spirit theory［D］.Nanjing：Nanjing University of Chinese Medicine，2024.
  71. 71.
    LI L，YANG M，HE H Q，et al.Effects of Cordyceps sinensis mycelium powder on Klotho gene and immunoregulation in rats with renal ischemia-reperfusion injury［J］.J Emerg Syndromes Tradit Clin Med，2016，25（7）：1290-1292，1311.
  72. 72.
    SONG L.Clinical observation and transcriptomic molecular mechanism study of tonifying kidney and expelling wind and dredging collateral in treating diabetic kidney disease（Qi-Yin deficiency and blood stasis syndrome）［D］.Chengdu：Chengdu University of Chinese Medicine，2023.
  73. 73.
    ZHANG D H，CHEN K L，DENG W，et al.Exploring the mechanism of Bushen Huoxue formula in treating uric acid nephropathy based on network pharmacology and molecular docking［J］.World Sci Technol Mod Tradit Chin Med，2022，24（8）：3137-3148.

Lire l'article complet

The above content is generated by Large Model Translation. The translated content is for reference only. We do not assume any commercial or legal responsibilty for any consequences arising from the use of our website