中药调控免疫系统治疗动脉粥样硬化研究进展  

Research progress in roles of traditional Chinese medicine in regulating immune system in treatment of atherosclerosis

作　　者：张丹丹[1,2] 韩汶润 朱彦 董鹏志[1,2] ZHANG Dan-dan;HAN Wen-run;ZHU Yan;DONG Peng-zhi(State Key Laboratory of Component-based Chinese Medicine,Tianjin University of Traditional Chinese Medicine,Tianjin 301608,China;Chinese Medicine New Drug Research and Development Center,Tianjin International Biomedical Research Institute,Tianjin 300457,China)

机构地区：[1]天津中医药大学组分中药国家重点实验室,天津301608 [2]天津国际生物医药联合研究院中药新药研发中心,天津300457

出　　处：《中国药理学与毒理学杂志》2021年第12期937-948,共12页Chinese Journal of Pharmacology and Toxicology

摘　　要：动脉粥样硬化(AS)是一种慢性炎症性疾病,始于动脉壁中低密度脂蛋白的沉积和积累,进而引起免疫细胞活化,包括单核细胞聚集、浸润、M1/M2巨噬细胞分化和淋巴细胞分化等。免疫细胞之间复杂的相互作用可调节促炎和抗炎反应之间的平衡,调节AS病变的进一步发展和稳定,在AS病理过程中发挥关键作用。因此,以免疫细胞活性为靶点可能开发出更具选择性和较小危害性的AS干预措施,同时保持宿主防御机制。中药方剂、组分和单体具有抗炎、调节血脂、改善血管微循环等多种作用,显示出治疗AS的巨大潜力,具有良好的临床应用前景。其中益气活血和清热解毒中药可降低黏附因子释放,抑制单核细胞黏附聚集,减少清道夫受体表达,从而降低巨噬细胞对氧化低密度脂蛋白的摄取,抑制泡沫细胞的形成;活血、补气通络中药调节炎症因子表达,改善血管微环境,促进巨噬细胞向M2型转化,减少树突状细胞(DC)数量,抑制DC成熟;补肾益肺健脾中药调节淋巴细胞亚型比例,改善机体免疫状态,调节机体阴阳平衡,使得免疫系统恢复正常。本文概述目前用于治疗AS中药的作用类型以及对免疫细胞调控的潜在靶点和(或)通路的理解,以期促进对AS免疫系统的认知,并为AS治疗提供新的研究思路。Atherosclerosis(AS) is a chronic inflammatory disease that begins with the deposition and accumulation of low-density lipoprotein in the arterial wall,resulting in activation of immune cells including monocyte aggregation and infiltration,differentiation of M1/M2 macrophages,and lymphocyte differentiation.The complex interactions between immune cells can regulate both the balance between proinflammatory and anti-inflammatory responses,and the further development and stability of atherosclerotic lesions,which plays a key role in the pathological process of AS.Therefore,targeting immune cell activity may lead to the development of more selective and less harmful AS interventions while leaving host defense mechanisms intact.Chinese medicine prescriptions,components and monomers display great potential in the treatment of AS due to their anti-inflammation,lipid regulation,improvement of vascular microcirculation and other functions,and have a good prospect of clinical application.Invigorating Qi and promoting blood circulation,clearing heat and detoxifying drugs can reduce the release of adhesive factors and inhibit the adhesion and aggregation of monocytes.The expression of scavenger receptors can be decreased,and the uptake of oxidized low density lipoprotein by macrophages is decreased,and the formation of foam cells is inhibited.Activating blood circulation,tonifying Qi and clearing collatals can regulate the expression of inflammatory factors,improve the vascular microenvironment,promote the transformation of macrophages into M2 type,reduce the number of dendritic cells(DC) and inhibit the maturation of DC.Tonifying the kidney,benefiting the lung and strengthening the spleen TCM can regulate the proportion of lymphocyte subtypes,improve the immune state of the body,adjust the balance of Yin and Yang of the body,and restore the immune system.This article summarizes the action types of some Chinese herbs currently used for the treatment of AS and the current understanding of potential targets/pathways of immune ce

关 键 词：动脉粥样硬化 先天性免疫反应 适应性免疫反应 中药 

分 类 号：R285[医药卫生—中药学] R967[医药卫生—中医学]