基于NF-κB信号通路探讨补肾活血法治疗腰椎间盘退行性变的作用机制  

Therapeutic Effect of Kidney Tonifying and Blood Activating Therapy Based onNF-κB Signaling Pathway in Treatment of Lumbar Disc Degeneration

作　　者：向婷 余彧 杨利学 XIANG Ting;YU Yu;YANG Lixue(The First Clinical Medical College of Shaanxi University of Chinese Medicine,Xianyang Shaanxi China 712000;Department of Spina,Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang Shaanxi China 712000)

机构地区：[1]陕西中医药大学第一临床医学院,陕西咸阳712000 [2]陕西中医药大学附属医院脊柱科,陕西咸阳712000

出　　处：《中医学报》2024年第4期730-736,共7页Acta Chinese Medicine

基　　金：陕西省自然科学基础研究计划项目(2018JM7128);咸阳市科技成果推广计划项目(2018KT-50);陕西省教育厅项目(18JK0210);杨利学名中医工作室项目。

摘　　要：髓核细胞数量的减少和细胞外基质代谢失衡、炎性反应、细胞因子氧化应激反应是腰椎间盘退行性变的主要表现。其主要病理机制是各种刺激下激活核因子-κB(nuclear factor-kappa B,NF-κB)信号通路,调节椎间盘内多种细胞因子、趋化因子、黏附分子、炎性介质和基质降解酶的表达,从而诱发腰椎间盘退行性变。补肾活血类中药延缓腰椎间盘退行性变的作用机制是减少由NF-κB信号通路活化后出现的炎性反应和氧化应激反应,从而保护髓核细胞及细胞外基质,减缓疾病进程。但目前机制研究仍存在一些局限:大量实验动物模型采用手术方式破坏椎间盘内结构,退变速度快于正常速度;实验研究的干预方式为单纯抑制某一个炎性因子,很难完全阻止疾病的进展;实验动物大多选用大鼠和兔的髓核细胞,与人的髓核细胞对某些刺激反应存在较大差异;抑制剂干预阻断某一细胞因子的再生,影响髓核再生功能的疗效持续时间短;由于中药成分的复杂性,很难明确阐释其影响NF-κB信号通路的具体机制;补肾活血法影响氧化应激反应方面的研究还有待深入。The decrease in the number of nucleus pulposus cells and the imbalance of extracellular matrix metabolism,inflammatory response,and cytokine oxidative stress response are the main manifestations of intervertebral disc degeneration.The main pathological mechanism is the activation of the nuclear factor-kappa B(NF-κB)signaling pathway under various stimuli,which regulating the expression of various cytokines,chemokines,adhesion molecules,inflammatory mediators and matrix degrading enzymes in the intervertebral disc,thereby inducing intervertebral disc degeneration.The mechanism of Chinese medicine formula for Kidney tonifying and blood activating in delaying intervertebral disc degeneration is to reduce the inflammatory and oxidative stress reactions that occur after activation of the NF-κB signaling pathway,thereby protecting nucleus pulposus cells and extracellular matrix as well as slowing down the progression of the disease.However,there are still some limitations in current understanding of those mechanisms.Surgical methods have been used in large number of experimental animal models to destroy the internal structure of intervertebral discs,resulting in a faster rate of degeneration than normal.The intervention method of experimental research is to simply inhibit a certain inflammatory factor,which is difficult to completely prevent the progression of the disease.Nucleus pulposus cells from rats or rabbits have been used in most experiments,which significantly different from human nucleus pulposus cells in response to certain stimuli.Inhibitors intervene to block the regeneration of a certain cytokine,affecting the function of nucleus pulposus regeneration with a short duration of therapeutic effect.Due to the complexity of Chinese medicine ingredients,it is difficult to explain the specific mechanism that how do they affect the NF-κB signaling pathway.Further research is needed on the effect of Kidney tonifying and blood activating method on oxidative stress response.

关 键 词：腰椎间盘退行性变 NF-ΚB信号通路 补肾活血法 炎症因子 氧化应激 

分 类 号：R259.815.3[医药卫生—中西医结合]