基于“炎症-组织”稳态偶联实现多发性硬化症髓鞘修复的研究现状及展望  

Research status and prospect of remyelination in multiple sclerosis based on "inflammation-tissue" homeostatic coupling

作　　者：杨丽娜 杜欣珂 刘丽[1] 李曼菁 冉庆森[1] 杨庆[1] 孙立东 李玉洁[1] 陈颖[1] 朱晓新[1] 李琦[1] YANG Li-na;DU Xin-ke;LIU Li;LI Man-jing;RAN Qing-sen;YANG Qing;SUN Li-dong;LI Yu-jie;CHEN Ying;ZHU Xiao-xin;LI Qi(Institute of Chinese Materia Medica,China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]中国中医科学院中药研究所,北京100700

出　　处：《中国中药杂志》2023年第1期5-12,共8页China Journal of Chinese Materia Medica

基　　金：中国中医科学院科技创新工程项目(CI2021A05105,CI2021B015);中国中医科学院优秀青年科技人才(创新类)培养专项(ZZ13-YQ-044);国家“重大新药创制”科技重大专项(2017ZX09101002-002-002);国家自然科学基金培育项目(L2020016)。

摘　　要：多发性硬化症(multiple sclerosis, MS)凸显中枢神经系统“炎性白质损伤”和“髓鞘修复失能”的双重病理特征。如何加强修复、改善机能、减少致残是MS治疗的核心目标和减轻疾病负担的关键。围绕这一目标,作者认为改变当下对免疫单向抑制策略的过分倚重,实现“促炎有度、消散有效”的炎症稳态才是加强髓鞘新生,维系组织“损伤-修复”稳态的基础。中药在其中具备良好的应用潜能。该文通过文献挖掘,以小胶质细胞为切入点,总结MS髓鞘修复的研究现状,梳理炎症“促-消”与组织“损-修”之间的平衡联动关联,展望未来实现MS髓鞘修复的重要治疗环节。为MS患者的机能改善治疗提供有效的理论储备;并基于“炎症-组织”稳态偶联的观点,为中药在其中的潜在应用提供合理的策略支持和药理研究方向指引。Multiple sclerosis(MS) shows the pathological characteristics of "inflammatory injury of white matter" and "myelin repair disability" in the central nervous system(CNS). It is very essential for MS treatment and reduction of disease burden to strengthen repair, improve function, and reduce disability. Accordingly, different from the simple immunosuppression, we believe that key to strengthening remyelination and maintaining the "damage-repair" homeostasis of tissue is to change the current one-way immunosuppression strategy and achieve the "moderate pro-inflammation-effective inflammation removal" homeostasis. Traditional Chinese medicine shows huge potential in this strategy. Through literature research, this study summarized the research on remyelination, discussed the "mode-rate pro-inflammation-effective inflammation removal" homeostasis and the "damage-repair" homeostasis based on microglia, and summed up the key links in remyelination in MS. This review is expected to lay a theoretical basis for improving the function of MS patients and guide the application of traditional Chinese medicine.

关 键 词：多发性硬化症 炎症稳态 组织稳态 髓鞘修复 小胶质细胞 

分 类 号：R744.51[医药卫生—神经病学与精神病学]