中药干预小胶质细胞表达治疗糖尿病神经痛研究进展  

Research Progress of Intervention of Chinese Materia Medica in Microglia Expression in the Treatment of Diabetic Neuropathic Pain

作　　者：魏晓涛 何志军[2] 刘涛 何元旭 马岁录 何波 王威威 WEI Xiaotao;HE Zhijun;LIU Tao;HE Yuanxu;MA Suilu;HE Bo;WANG Weiwei(Gansu University of Chinese Medicine,Lanzhou 730000,China;Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730050,China;The Fourth Affiliated Hospital of Gansu University of Chinese Medicine,Lanzhou 730000,China)

机构地区：[1]甘肃中医药大学,甘肃兰州730000 [2]甘肃省中医院,甘肃兰州730050 [3]甘肃中医药大学第四附属医院,甘肃兰州730000

出　　处：《中国中医药信息杂志》2023年第3期171-176,共6页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：甘肃省重点研发计划(21YF5FA021);甘肃省青年科技基金计划(21JR11RA211)。

摘　　要：糖尿病神经痛是以夜间加重性、对称性远端肢体疼痛为主要表现的糖尿病痛性周围神经病变。部分糖尿病患者周围神经发生病变时,维持中枢神经系统稳态的小胶质细胞在核因子-κB、Notch、丝裂原活化蛋白激酶、Toll样受体4、c-Jun氨基端激酶-STAT等信号通路和核苷酸结合寡聚结构域样受体热蛋白结构域相关蛋白3(NLRP3)炎症小体等信号因子介导下发生“变形虫样”形变,激活变形为具有促炎作用的M1型和抗炎作用的M2型。其中M1型小胶质细胞迅速激活并释放相关促炎因子、毒性物质杀灭病原体,触发并加重炎症反应,发挥保护性应激作用;M2型小胶质细胞激活并分泌相关抑炎因子,以达到减轻神经炎性水肿、促进神经组织修复再建、保护病变神经、缓解神经炎性疼痛的作用。而中药具有整体调节、多靶点、多系统作用且不良反应小的特点,并可通过相关信号通路和信号因子调控小胶质细胞形态改变、加快M2型极化、防止小胶质细胞过度激活,以达到防治糖尿病神经痛目的。本文对小胶质细胞不同形态在糖尿病神经痛发病中的作用,部分相关信号通路和信号因子对小胶质细胞的影响,以及中药有效成分在小胶质细胞形态改变、促炎因子和抑炎因子表达中的作用进行综述,以期为中医药防治糖尿病神经痛提供依据,并为后续相关研究提供思路。Diabetic neuropathic pain(DNP)is a painful diabetic peripheral neuropathy characterized by nighttime aggravation and symmetrical distal limb pain.Studies have found that when peripheral neuropathy occurs in some diabetic patients,microglia that maintain the steady state of the central nervous system undergo“metamorphosis”deformation mediated by NF-κB,Notch,MAPK,TLR4,JAK-STAT signaling pathway and NLRP3inflammatory cytokines,which is activated and transformed into M1 type with pro-inflammatory effect and M2 type with anti-inflammatory effect.Among them,M1 type microglia rapidly activates and releases related pro-inflammatory signaling factors and toxic substances to kill pathogens and aggravate inflammatory reactions,playing a protective role in stress.Subsequently,the slowly polarized M2 microglia activates and secretes relevant anti-inflammatory factors to reduce neuroinflammatory edema,promote nerve tissue repair and reconstruction,protect the diseased nerves,and alleviate neuropathic pain.Modern pharmacological studies have shown that Chinese materia medica has the characteristics of overall regulation,multi-target,multi-system and small side effects,which can regulate the morphological changes of microglia through relevant signaling pathways and signaling factors,accelerate M2polarization,and prevent excessive activation of microglia to achieve the purpose of prevention and treatment of DNP.This paper reviewed the role of different forms of microglia in the pathogenesis of DNP,the influence of some related signaling pathways and signaling factors on microglia,and the role of effective components of Chinese materia medica in the morphological changes of microglia,the expression of pro-inflammatory factors and anti-inflammatory factors,in order to provide basis for the prevention and treatment of DNP and provide ideas for subsequent related research.

关 键 词：糖尿病神经痛 小胶质细胞 炎症因子 信号通路 中药 综述 

分 类 号：R259.871[医药卫生—中西医结合]