中医药对血管性认知障碍中调节性细胞死亡的调控作用研究进展  

Traditional Chinese Medicine Regulation of Regulated Cell Death in Vascular Cognitive Impairment:A Review

作　　者：钟奕 黄川 孙乐[1,2] 马培[1,2] 许利嘉[1,2] 肖培根[1,2] ZHONG Yi;HUANG Chuan;SUN Le;MA Pei;XU Li-jia;XIAO Pei-gen(Institute of Medicinal Plant Development,Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing 100193,China;Key Laboratory of Bioactive Substances and Resources Utilization of Chinese Herbal Medicine,Ministry of Education,Beijing 100193,China)

机构地区：[1]中国医学科学院北京协和医学院药用植物研究所,北京100193 [2]教育部中草药物质基础与资源利用重点实验室,北京100193

出　　处：《中国现代中药》2024年第2期412-424,共13页Modern Chinese Medicine

基　　金：国家自然科学基金项目(82174046);中国医学科学院医学与健康科技创新工程项目(2021-I2M-1-031);广西科技基地和人才专项(AD22080012)。

摘　　要：血管性认知障碍(VCI)是由脑血管病危险因素、明显或不明显脑血管病引起的,涵盖从轻度认知障碍到痴呆的一大类综合征,其发病率呈逐年上升的趋势,严重威胁老年人生活质量。调节性细胞死亡(RCD)是可调控的细胞死亡方式,包括细胞程序性坏死、自噬、细胞焦亡等多种形式,拥有独特的生化、形态特征。研究表明,缺血条件下调控RCD可促进细胞生存、减少神经细胞死亡,在延缓VCI的发生发展中具有较大的作用。化学药治疗VCI主要对改善血管风险因素及对发展到痴呆阶段后的认知能力进行干预,使用临床已成熟的药物较多,用药安全,但药效一般,对神经细胞的RCD调控较少。临床上也广泛使用中医药治疗VCI,疗效较好,但尚未明确其具体机制,其与RCD的关系也缺少相关总结。综述VCI中铁死亡、细胞焦亡、线粒体自噬及依赖性细胞死亡等不同形式RCD的研究进展,中医药对RCD的调控、对VCI的治疗作用,以期为探索临床VCI治疗的潜在靶点提供新的视角。Vascular cognitive impairment(VCI)is a major syndrome caused by cerebrovascular risk factors as well as conspicuous or unconspicuous cerebrovascular diseases,covering a large category of syndromes from mild cognitive impairment to dementia.Its incidence shows a rising trend year by year,which seriously threatens the quality of life of the elderly.Regulated cell death(RCD)is a regulated mode of cell death that includes various forms such as programmed cell necrosis,autophagy,and cell pyroptosis,with unique biochemical and morphological characteristics.Research has confirmed that regulating RCD under ischemic conditions can promote cell survival and reduce neuronal death,playing a significant role in delaying the occurrence and development of VCI.The treatment of VCI with normal medicine mainly aims to improve vascular risk factors and intervene in cognitive ability after developing to dementia stage.There are a variety of medicines that are commonly used in clinical practice with safety,but their efficacy is average and there is less regulation of RCD in neural cells.Traditional Chinese medicine is also widely applied to treat VCI in clinical practice,with desirable effects.However,its mechanism is not yet clear,and few relevant summaries are found on its relationship with RCD.This paper reviewed the research progress on different forms of RCD in VCI,including ferroptosis,cell pyroptosis,mitochondrial autophagy,and dependent cell death.It also discussed the regulatory effect of traditional Chinese medicine on RCD in the treatment of VCI,to provide a new perspective for exploring potential targets for clinical VCI treatment.

关 键 词：调节性细胞死亡 血管性认知障碍 脑血管病 中药 

分 类 号：R282[医药卫生—中药学]