中医药及活性成分靶向M1/M2巨噬细胞极化平衡治疗慢性阻塞性肺疾病的研究进展  

Traditional Chinese medicine and active ingredients regulate M1/M2 macrophage polarization balance to treat chronic obstructive pulmonary disease:a review

作　　者：邓亚胜 范燕萍 郑艺清 习兰花 李汶玥 梁天薇 黄慧 林江 DENG Ya-sheng;FAN Yan-ping;ZHENG Yi-qing;XI Lan-hua;LI Wen-yue;LIANG Tian-wei;HUANG Hui;LIN Jiang(School of Basic Medical Sciences,Guangxi University of Chinese Medicine,Nanning 530200,China;Hainan Hospital of Traditional Chinese Medicine,Haikou 570100,China)

机构地区：[1]广西中医药大学基础医学院,广西南宁530200 [2]海南省中医院,海南海口570100

出　　处：《中国中药杂志》2024年第16期4298-4312,共15页China Journal of Chinese Materia Medica

基　　金：国家自然科学基金项目(82060825);全国高校黄大年式教师团队“中西医基础课程教师团队”项目(教育部教师函[2022]2号);中医学广西一流学科项目(桂教科研[2022]1号);广西中医药多学科交叉创新团队项目(GZKJ2302);广西名中医林江传承工作室项目(桂中医药科教发[2021]6号)。

摘　　要：慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)是一种因长期吸入有毒颗粒,特别是吸烟所导致的进行性肺功能障碍(疾病),持续接触这些有害物质会引发异常的炎症反应,进而造成呼吸系统永久性损伤,最终导致不可逆的病理变化。肺巨噬细胞(lung macrophages,LMs)是关键的先天免疫效应细胞,在识别、吞噬和清除病原体,以及处理吸入的有害颗粒物(如香烟烟雾和颗粒物PM)方面扮演着重要角色。LMs在炎症因子的激活下向M1或M2方向极化,分别发挥着促炎/抗炎作用,参与COPD肺实质的损伤(肺气肿)和修复(气道重塑)的全过程。它们还负责吞噬和清除凋亡或坏死的组织细胞,共同维护COPD患者肺内的微环境稳定。现代研究揭示,巨噬细胞极化在COPD的发病与发展中占据着举足轻重的地位,其具备减轻气道炎症、抑制组织重塑,以及抗氧化应激等多重功效,因此被视为COPD治疗的潜在靶点。近年来,中医药及其活性成分靶向M1/M2巨噬细胞极化平衡治疗COPD的研究成为热点领域,以巨噬细胞极化状态的调节为目标,通过中医药及其活性成分的干预平衡COPD患者肺组织中的炎症反应,并促进修复过程。该文深入探讨了近年中医药及其活性成分在这一领域的研究成果,旨在为COPD的精准诊疗策略提供新的科学依据和有力支持。Chronic obstructive pulmonary disease(COPD)is a progressive lung dysfunction(disease)caused by long-term inhalation of toxic particles,especially smoking.The continued exposure to harmful substances triggers an abnormal inflammatory response,which causes permanent damage to the respiratory system,ultimately leading to irreversible pathological changes.Lung macrophages(LMs)are key innate immune effectors involved in the recognition,phagocytosis,and clearance of pathogens,as well as in the processing of inhaled hazardous particulate matter(e.g.,cigarette smoke and particulate matter).LMs are polarized toward the M1 or M2 phenotype in response to the activation of inflammatory mediators to exert pro-/anti-inflammatory effects,respectively,thus being involved in the pulmonary parenchymal damage(emphysema)and repair(airway remodeling)throughout the process of COPD.In addition,they are responsible for phagocytosis and clearance of apoptotic or necrotic tissue cells,which helps to maintain the stability of the microenvironment in the lungs of COPD patients.Modern studies have revealed that macrophage polarization plays a pivotal role in the pathogenesis and development of COPD and is considered a potential target for treating COPD because of its ability to reduce airway inflammation,inhibit tissue remodeling,and combat oxidative stress.In recent years,traditional Chinese medicine(TCM)and its active ingredients have become a hot area in the treatment of COPD by targeting the balance of M1/M2 macrophage polarization.TCM and its active ingredients can intervene in the inflammatory response to promote the repair of the lung tissue in the patients with COPD.This paper reviews the research achievements of TCM and its active ingredients in this field in recent years,aiming to provide a scientific basis and strong support for the precise diagnosis and treatment of COPD.

关 键 词：慢性阻塞性肺疾病 巨噬细胞极化 肺巨噬细胞 中医药 有效成分 研究进展 

分 类 号：R259[医药卫生—中西医结合]