NLRP3炎症小体在糖尿病神经病变中的作用及中医药防治的研究进展  

Role of NLRP3 inflammasome in diabetic neuropathy and prevention and treatment with traditional Chinese medicine

作　　者：冯皓月 丁蕊 周琦 吴挺超 李慧 马喜桃[1] 岳仁宋[1] FENG Hao-yue;DING Rui;ZHOU Qi;WU Ting-chao;LI Hui;MA Xi-tao;YUE Ren-song(Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610072,China;Department of Ophthalmology,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,China;Chengdu Second People′s Hospital,Chengdu 610000,China;School of Acupuncture and Moxibustion,Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610097,China)

机构地区：[1]成都中医药大学附属医院,四川成都610072 [2]西南医科大学附属医院眼科,四川泸州646000 [3]成都市第二人民医院,四川成都610000 [4]成都中医药大学附属医院针灸学校,四川成都610097

出　　处：《中国中药杂志》2023年第2期300-310,共11页China Journal of Chinese Materia Medica

基　　金：四川省科学技术厅重点研发项目(2021YFS0037);四川省中医药管理局项目(2020LC0153)。

摘　　要：糖尿病神经病变是糖尿病最常见的并发症之一,常累及周围神经系统和中枢神经系统。神经炎症是糖尿病继发神经损伤的关键致病因素。NOD样受体热蛋白3(NOD-like receptor pyrin domain-containing 3,NLRP3)炎症小体是一组亚细胞多蛋白复合物,包括NLRP3、凋亡相关斑点样蛋白(apoptosis associated speck-like protein,ASC)和前天冬氨酸特异性半胱氨酸蛋白酶1(pro-cysteinyl aspartate specific proteinase 1,pro-caspase-1),其作为先天免疫反应的诱导剂,激活后诱发的炎症级联反应通过产生和释放炎症介质、触发细胞焦亡和自噬失控、诱导神经胶质细胞活化、增加外周免疫细胞浸润以及促进淀粉样蛋白β(amyoidβ,Aβ)-tau级联等参与糖尿病继发的中枢神经、躯体神经、自主神经以及视网膜神经细胞的损伤。因此,作为诱导神经炎症的核心位点,NLRP3炎症小体可能为糖尿病神经病变的治疗提供新的靶点。中医药具有多靶点、低毒、副作用少的优势,在糖尿病神经病变中扮演重要角色,并且有一定数量的研究报道了中医药对糖尿病神经病变的积极作用可能来自于对NLRP3炎症小体的调控。尽管已经有文献归纳总结了NLRP3炎症小体在糖尿病及相关并发症中的作用,但并未系统囊括继发神经病变的药物汇总及机制分析。因此,该文就NLRP3炎症小体在糖尿病神经病变中的作用以及中医药经NLRP3炎症小体的进展进行综述。As one of the most frequent complications of diabetes,diabetic neuropathy often involves peripheral and central nervous systems.Neuroinflammation is the key pathogenic factor of secondary nerve injury in diabetes.NOD-like receptor pyrin domain-containing 3(NLRP3)inflammasome is a group of subcellular multiprotein complexes,including NLRP3,apoptosis associated speck-like protein(ASC),and pro-cysteinyl aspartate specific proteinase 1(pro-caspase-1).NLRP3 inflammasome is an inducer of innate immune responses.Its activation stimulates the inflammatory cascade reaction,promotes the release of inflammatory mediators,triggers cell death and uncontrolled autophagy,activates glial cells,facilitates peripheral immune cell infiltration,and initiates amyoidβ(Aβ)-tau cascade reactions.As a result,it contributes to the central nerve,somatic nerve,autonomic nerve,and retinal nerve cell damage secondary to diabetes.Therefore,due to its key role in the neuroinflammation responses of the body,NLRP3 inflammasome may provide new targets for the treatment of diabetic neuropathy.With multi-target and low-toxicity advantages,traditional Chinese medicine plays a vital role in the treatment of diabetic neuropathy.Accumulating evidence has shown that traditional Chinese medicine exerts curative effects on diabetic neuropathy possibly through regulating NLRP3 inflammasome.Although the role of NLRP3 inflammasome in diabetes and related complications has been investigated in the literature,systematical studies on drugs and mechanism analysis for secondary neuropathy are still lacking.In this article,the role of NLRP3 inflammasome in diabetic neuropathy was explored,and the research progress on traditional Chinese medicine in the treatment of diabetic neuropathy through NLRP3 inflammasome was reviewed.

关 键 词：糖尿病神经病变 中枢神经系统 周围神经系统 NLRP3炎症小体 神经炎症 中医药 

分 类 号：R587.2[医药卫生—内分泌]