中医药干预自身免疫性甲状腺疾病Th17/Treg平衡的研究进展  

Research Progress of Intervention in Autoimmune Thyroid Diseases Based on Th17/Treg Signal Axis with Traditional Chinese Medicine

作　　者：张艳[1] 谢敏 左新河[1,2] 赵勇[1,2] 华川 ZHANG Yan;XIE Min;ZUO Xin-he;ZHAO Yong;HUA Chuan(Hubei University of Chinese Medicine,Wuhan 430061,China;Hubei Provincial Hospital of Traditional Chinese Medicine,Wuhan 430074,China)

机构地区：[1]湖北中医药大学,武汉430061 [2]湖北省中医院,武汉430074

出　　处：《中国实验方剂学杂志》2021年第10期231-238,共8页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：湖北省自然科学基金面上项目(2019CFB800);国家中医药管理局全国名中医工作室建设项目(国中医药办人教函[2018]119号);国家中医药管理局全国中医学术流派传承工作室第二轮建设项目(国中医药人教函[2019]62号)。

摘　　要：自身免疫性甲状腺疾病(AITD)是一种复杂的器官特异性自身免疫性疾病,与遗传易感性、环境因素、免疫系统障碍和肠道微生物群失衡等诸多因素有关,严重影响人们生活质量。目前西医临床上主要以口服药物、碘131治疗和手术治疗为主,虽能发挥一定疗效,但存在手术风险和药物副作用。现代研究表明,中医药具有疗效稳定、多靶向调节、副反应少的治疗特点,防治AITD方面疗效确切、优势独特。辅助性T淋巴细胞17(Th17)介导炎症引起免疫促进,调节性T淋巴细胞(Treg)介导免疫抑制,Th17和Treg协同维持着机体免疫微环境的平衡。在AITD进展期间,引起炎症的Th17可呈现高水平,而介导免疫抑制Treg水平相对减低,恢复两者平衡在AITD的炎症和免疫过程中起关键作用。近年来,中医药领域以Th17/Treg轴为切入点,开展了大量中医药干预AITD中Th17/Treg平衡的临床和实验研究,并取得了一定的成果,研究表明干预Th17/Treg信号轴是治疗AITD的重要作用机制。笔者就前人关于中药单体、中药成分和中药复方对AITD中Th17/Treg细胞轴干预作用的研究进行总结与分析,主要从干预相关炎性因子分泌、调节甲状腺过氧化物酶抗体(TPOAb)和抗甲状腺球蛋白抗体(TGAb)等抗体滴度及影响相关基因的表达等方面进行归纳阐述,有利于人们更为准确、全面地认识中医药干预AITD中Th17/Treg平衡的作用机制,为临床合理应用中医药防治AITD提供参考。Autoimmune thyroid disease(AITD)is a complex organ-specific autoimmune disease,associated with many factors such as genetic susceptibility,environmental factors,immune system disorders,and intestinal microbiota imbalance,which seriously affect the quality of life. At present,oral medicine,iodine 131 treatment and surgical treatment are mainly adopted in clinical parctice of western medicine. Although they can exert a certain curative effect,they still have surgical risks and side effect. Modern research shows that,traditional Chinese medicine(TCM)has the characteristics of stable curative effect,multi-targeted regulation and less side effect. It has definite efficacy and unique advantages in the prevention and treatment of AITD.Helper T lymphocyte cell 17(Th17)mediate inflammation to induce immune promotion,while regulatory T lymphocyte cell(Treg)mediate immunosuppression,Th17 and Treg cooperate to maintain the balance of the immune microenvironment. During AITD progress,Inflammatory Th17 can be high,and the levels of mediated immunosuppressive Treg are relatively decreased. The restoration of balance between the two plays a key role in the inflammatory and immune processes of AITD. In recent years,based on Th17/Treg cell axis,a large number of clinical and experimental studies on the intervention of TCM on Th17/Treg balance in AITD have been carried out in the field of TCM,and some results have been achieved. Studies have shown that intervention in the Th17/Treg signaling axis is an important mechanism for the treatment of autoimmune thyroid diseases. This paper summarizes and analyzes the previous studies on the intervention effect of Chinese medicine monomer,Chinese medicine composition and Chinese medicine compound on Th17/Treg cell axis in AITD,mainly from the aspects of intervention related inflammatory factor secretion,regulation of antibody titer and the expression of related genes of related genes. These studies will help people to understand the mechanism of TCM in interfering with the Th17/Treg balance

关 键 词：自身免疫性甲状腺疾病 辅助性T淋巴细胞17(Th17)/调节性T淋巴细胞(Treg) 中医药 信号通路 

分 类 号：R22[医药卫生—中医基础理论] R242[医药卫生—中医学]