中药调控膝骨关节炎相关信号通路的研究进展  

Chinese Medicine Regulates Knee Osteoarthritis-related Signaling Pathways:A Review

作　　者：傅永升 谭茗月 王卫国[1,2] 赵明华 李琦 徐小东[1] 赵建鹏 赵文卓 FU Yongsheng;TAN Mingyue;WANG Weiguo;ZHAO Minghua;LI Qi;XU Xiaodong;ZHAO Jianpeng;ZHAO Wenzhuo(Shandong University of Traditional Chinese Medicine(TCM),Jinan 250013,China;Affiliated Hospital of Shandong University of TCM,Jinan 250011,China)

机构地区：[1]山东中医药大学,济南250013 [2]山东中医药大学附属医院,济南250011

出　　处：《中国实验方剂学杂志》2023年第22期231-243,共13页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：中国中医药研究促进会项目(2021年第18号);济南市临床医学科技创新计划项目(202019115);山东省中医药科技项目(2021M173)。

摘　　要：随着中医药对膝骨关节炎(KOA)研究的不断深入,现代学者发现诸多中药可从分子层面干预信号通路延缓膝骨关节炎的进展。文中所述中药及其活性成分在干预膝骨关节炎的机制中与信号通路有着密切关系。中药及有效成分可在不同信号通路的传导下调控相应的靶向分子水平,抑制软骨炎性因子、细胞凋亡、软骨基质降解及促进软骨细胞自噬,以达到减轻滑膜炎性水肿和延缓软骨退变的目的。现对国内外中药干预KOA的研究进行系统性总结:黄芩素等可通过阻断磷脂酰肌醇3-激酶/蛋白激酶B(PI3K/Akt)信号通路,减少软骨细胞炎性因子、凋亡及促进自噬;山茱萸新苷Ⅰ等成分降低Janus激酶2/信号转导和转录激活因子3(JAK2/STAT3)通路磷酸化活性改善滑膜炎症、延缓软骨基质退变;丹酚酸A等中药活性成分可通过抑制核转录因子-κB(NF-κB)通路磷酸化,减轻炎症与软骨基质降解;大黄素等有效成分可降低Wnt/β-连环蛋白(Wnt/β-catenin)通路活性,抑制胶原蛋白与蛋白多糖分解;肉豆蔻苷等通过阻断p38丝裂原活化蛋白激酶(p38 MAPK)信号传导,抑制细胞凋亡;木通皂苷D等可增强核因子E2相关因子2/血红素加氧酶1(Nrf2/HO-1)通路活性,抑制软骨细胞氧化应激;牛膝总皂苷等通过增强转化生长因子-β(TGF-β)/Smad信号传导,减少软骨基质降解;藏红花素通过激发河马/Yes相关蛋白(Hippo/YAP)活性抑制软骨炎症与凋亡因子增加;川芎嗪阻断Notch通路改善软骨细胞形态与异常;齐墩果酸等通过发挥雌激素信号通路,减轻软骨基质破坏与退变。以上总结旨在为今后开展KOA临床与实验研究提供借鉴。As the research of traditional Chinese medicine(TCM)on knee osteoarthritis(KOA)is progressing,researchers have discovered that a variety of Chinese medicines can delay the progress of KOA by regulating signaling pathways at the molecular level.The Chinese medicines and their active ingredients mentioned in this article are associated with the signaling pathways in KOA.They can regulate the levels of targeted molecules via different signaling pathways to inhibit cartilage inflammatory cytokine,apoptosis,and cartilage matrix degradation and promote chondrocyte autophagy,so as to reduce the synovial inflammatory edema and delay cartilage degeneration.This paper systematically reviews the studies about the TCM intervention of KOA.Baicalein can reduce the inflammatory cytokines and apoptosis and promote the autophagy of chondrocytes by blocking the phosphatidylinositol-3 kinase/protein kinase(PI3K/Akt)signaling pathway.Cornuside I can decrease the phosphorylation activity of Janus kinase 2/signal transducer and activator of transcription 3(JAK2/STAT3)pathway to reduce synovial inflammation and delay cartilage matrix degeneration.Salvianolic acid A can reduce inflammation and cartilage matrix degradation by inhibiting the phosphorylation of the nuclear factor-κB(NF-κB)pathway.Emodin can reduce the activity of Wnt/β-catenin pathway to inhibit the decomposition of collagen and proteoglycan.Myristicoside can inhibit apoptosis by blocking the p38 mitogenactivated protein kinase(p38 MAPK)signaling pathway.Akebia saponin D can enhance the activity of nuclear factor E2-related factor 2/heme oxygenase 1(Nrf2/HO-1)pathway to inhibit oxidative stress in chondrocytes.The saponins in Achyranthis Bidentatae Radix reduce cartilage matrix degradation by enhancing the transforming growth factor-β(TGF-β)/Smad signaling pathway.Crocin inhibits the cartilage inflammation and apoptosis factor increase by stimulating the activity of hippo-Yes-associated protein(Hippo-YAP).Ligustrazine blocks the Notch pathway to improve the morphology

关 键 词：中药 膝骨关节炎 信号通路 活性成分 炎性因子 研究进展 

分 类 号：R2-0[医药卫生—中医学] R33[文化科学—情报学] R684.3G353.11