基于PI3K/AKT信号通路探讨中医药干预糖尿病血管病变的研究进展  

Research progress of TCM Intervention in diabetic angiopathy based on PI3K/AKT signaling pathway

作　　者：刘彦彤 王郁金[1] 苏衍进[2] 谭从娥[1] 王相东 邢文文[1] LIU Yantong;WANG Yujin;SU Yanjin;TAN Cong’e;WANG Xiangdong;XING Wenwen(Shaanxi University of Chinese Medicine,Xianyang 712046,China)

机构地区：[1]陕西中医药大学基础医学院,咸阳712046 [2]陕西中医药大学第一附属医院内分泌科

出　　处：《环球中医药》2023年第1期175-181,共7页Global Traditional Chinese Medicine

基　　金：陕西省科技厅重点研发计划(2020SF-336)。

摘　　要：糖尿病血管病变是糖尿病最常见且严重并发症之一。磷脂酰肌醇3-激酶(phosphoinsoitide 3-kinase,PI3K)/蛋白激酶B(protein kinase B,AKT/PKB)是胰岛素传导的主要途径之一,具有调控细胞生长、凋亡、糖脂代谢等功能。中医药在面对多靶点的信号通路时有着巨大优势,中医药通过干预AKT下游靶蛋白内皮型一氧化氮合酶(endothelial nitric oxide synthase,eNOS)产生一氧化氮(nitric oxide,NO)恢复血管内皮功能,减缓动脉粥样硬化(atherosclerosis,AS)进程;上调血管内皮生长因子(vascular endothelial growth factor,VEGF)加速糖尿病疮面伤口微血管生成,促进伤口愈合;下调VEGF,减少大血管与视网膜病理性微血管生成,缓解AS与糖尿病视网膜病变进程;改善胰岛素抵抗,提高葡萄糖利用率,减弱高糖引起的血管内损伤,缓解内环境代谢紊乱造成的炎症介质与氧化应激反应;抑制核因子-κB(nuclear factor kappa-B,NF-κB)抑制炎症因子生成并对血管的黏附;上调抗凋亡蛋白与下调促凋亡蛋白提高终末分化心肌或周细胞生存率,减缓糖尿病血管病变(Diabetic angiopathies,DA)冠心病与视网膜病变的发展。因此,本文将从PI3K/AKT有关靶蛋白、糖尿病血管病变与中医药干预3个方面进行概述。以期为糖尿病血管病干预提供参考和研究方向。Diabetic angiopathy(DA)is one of the most common and serious complications of diabetes.Phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt/PKB)is one of the main pathways of insulin transmission,which has the functions of regulating cell growth,apoptosis,glucose and lipid metabolism.Traditional Chinese medicine has great advantages in multi-target signal pathways.Traditional Chinese medicine can intervene the target protein endothelial nitric oxide synthase(eNOS)downstream of Akt to produce nitric oxide(NO),restore vascular endothelial function and slow down the process of arteriosclerosis(AS);the up-regulation of vascular endothelial growth factor(VEGF)accelerates microvasculature and promotes wound healing in diabetic wounds.The Down-regulation of VEGF can reduce the pathological angiogenesis of large vessels and retina,and alleviate the progression of AS and diabetic retinopathy.Improve insulin resistance,improve glucose utilization,weaken intravascular injury caused by high glucose,and alleviate inflammatory mediators and oxidative stress caused by metabolic disorder of internal environment;Inhibitory nuclear factor-κB(NF-κB)Inhibit the production of inflammatory factors and adhesion to blood vessels;the up-regulation of anti apoptotic protein and the down-regulation of pro apoptotic protein can improve the survival rate of terminal differentiation myocardium or pericytes,and slow down the development of coronary heart disease and retinopathy in DA.Therefore,this article will outline 3 aspects of PI3K/AKT target protein,DA and Chinese medicine intervention.In order to provide reference and research direction for diabetic vascular disease intervention.

关 键 词：磷脂酰肌醇3-激酶/蛋白激酶B 糖尿病血管病变 中医药 动脉粥样硬化 糖尿病溃疡 糖尿病视网膜病变 代谢 炎症 

分 类 号：R285.5[医药卫生—中药学]