中药调控间充质干细胞外泌体治疗缺血性心脑血管疾病研究进展  

Traditional Chinese Medicine Regulation of Mesenchymal Stem Cell-derived Exosomes in Treatment of Ischemic Cardiovascular and Cerebrovascular Diseases:A Review

作　　者：解冬 张露 张金生[2] XIE Dong;ZHANG Lu;ZHANG Jinsheng(Henan University of Chinese Medicine,Zhengzhou 450046,China;The Third Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学,郑州450046 [2]河南中医药大学第三附属医院,郑州450000

出　　处：《中国实验方剂学杂志》2024年第13期250-258,共9页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：中原科技创新领军人才项目(214200510022);河南省中医药科学研究专项(2022ZY1110)。

摘　　要：缺血性心脑血管疾病包括缺血性心脏病和缺血性脑血管病,具有高患病率、高致残率、高死亡率的特点,目前已成为全球死亡原因首位。缺血性心脏病和缺血性脑血管病的共同病因是血管狭窄、粥样硬化及梗死造成的局部供血减少,而其复杂的病理过程涉及炎症、焦亡、凋亡、自噬等多种机制,干预单一的病理环节治疗作用有限,亟需寻找可同时干预多个病理环节的新的治疗策略或药物。间充质干细胞通过其旁分泌效应起到组织修复的作用,外泌体在其中扮演重要角色,间充质干细胞外泌体具有与母细胞相似的免疫调节和修复特性,同时可减少干细胞直接应用后的不良反应及输注毒性,其在治疗缺血性心脑血管疾病中具有广泛应用前景。中药及组方具有多成分、多靶标、多层次系统调节的作用特点,中药可通过对间充质干细胞源性外泌体的调控改善细胞微环境从而对缺血性心脑血管疾病发挥治疗作用,体现现代中医微观辨证的观点,是中医药现代化的又一重要领域。该文对间充质干细胞外泌体对缺血性心脑血管疾病的治疗作用及机制进行了综述,同时讨论了中药调控间充质外泌体在缺血性心脑血管疾病中的应用作用,为中医药防治缺血性心脑血管病提供新思路。Ischemic cardiovascular and cerebrovascular diseases,encompassing ischemic heart disease and ischemic cerebrovascular disease,possess the features of high prevalence,disability,and mortality rates,thus ranking as the leading cause of global mortality.The shared etiology of ischemic heart disease and ischemic cerebrovascular disease involves local hypoperfusion caused by vascular stenosis,atherosclerosis,and infarction.Their intricate pathological processes involve various mechanisms such as inflammation,pyroptosis,apoptosis,and autophagy.However,interventions targeting individual pathological pathways offer limited therapeutic effects.There is an urgent need to explore novel treatment strategies or medications capable of simultaneously intervening in multiple pathological pathways.Mesenchymal stem cells,through their paracrine effects,play a role in tissue repair,with exosomes playing an important role.Mesenchymal stem cell-derived exosomes exhibit immunomodulatory and reparative properties similar to their parent cells while also reducing the side effects and infusion toxicity associated with the direct application of stem cells.Thus,they hold broad prospects for the treatment of ischemic cardiovascular and cerebrovascular diseases.Traditional Chinese medicine(TCM)and formulations,with their characteristics of multiple components,targets,and multi-level system regulation,can improve the cellular microenvironment by modulating mesenchymal stem cell-derived exosomes,thereby exerting therapeutic effects on ischemic cardiovascular and cerebrovascular diseases.This viewpoint highlights the concept of microscopic pattern differentiation in modern TCM and represents another significant area of TCM modernization.This article provided a comprehensive overview of the therapeutic effects and mechanisms of mesenchymal stem cell-derived exosomes in ischemic cardiovascular and cerebrovascular diseases while discussing the application of TCM in regulating mesenchymal stem cell-derived exosomes in ischemic cardiovascular and ce

关 键 词：中医药 间充质干细胞 外泌体 缺血性心脏病 缺血性脑血管疾病 

分 类 号：R2-0[医药卫生—中医学] R22R242R287