补肾中药调控骨髓间充质干细胞防治多发性硬化的机制探索  

Mechanism exploration of kidney-tonifying medicines on treating multiple sclerosis via the regulation of bone marrow mesenchymal stem cells

作　　者：李春雨 王蕾[1] LI Chunyu;WANG Lei(School of Traditional Chinese Medicine,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学中医药学院,北京100069

出　　处：《环球中医药》2024年第9期1713-1718,共6页Global Traditional Chinese Medicine

基　　金：国家自然科学基金(82274450)。

摘　　要：髓鞘再生障碍是脱髓鞘疾病如多发性硬化(multiple sclerosis,MS)的重要病理环节,而中医药具有促进髓鞘再生的潜在优势。中医学认为,肾藏精,精化髓,髓上行充脑。MS患者的基本病机为肾精亏虚,脑髓失养,损伤的轴突再髓鞘化困难,从而导致神经功能障碍。因此补肾生髓为其根本治法,补肾中药治疗MS疗效显著。研究发现,骨髓间充质干细胞(bone marrow mesenchymal stem cells,BMSCs)是一类具有强大分化潜能的多能干细胞,其分泌的外泌体可透过血脑屏障,其功能特点与中医肾藏精主骨生髓充脑的理论具有高度相关性,且BMSCs对MS也有良好的治疗作用。研究还证实,补肾中药可促进BMSCs增殖分化、定向迁移和调节自噬与凋亡。因此推测补肾中药调控BMSCs可能是其防治MS的机制之一。本研究为中医药防治MS等脱髓鞘疾病提供了新思路。Myelinal regeneration disorder is an important pathological factor in demyelinating diseases such as multiple sclerosis(MS),and traditional Chinese medicine(TCM)has shown the potential advantages in promoting remyelination.According to the theory of TCM,kidney stores essence,which generates marrow,marrow ascends to nourish the brain.The basic pathogenesis of MS involves kidney essence deficiency,insufficient nourishment of the brain marrow and difficulties in remyelinating damaged axons,resulting in neurological dysfunction.Therefore,tonifying kidney and regenerating marrow is its essential therapeutic method.Kidney-tonifying medicines have shown notable efficacy in treating MS.Research found that bone marrow mesenchymal stem cells(BMSCs)are the pluripotent stem cells with strong differentiation potential.The exosomes secreted by BMSCs can cross the blood-brain barrier.The functional characteristics of BMSCs are highly correlated with the TCM theory of kidney storing essence,dominating bone,generating marrow and enriching the brain,and BMSCs also have good therapeutic effects on MS.The study also confirmed that kidney-tonifying medicines can promote the proliferation,differentiation,directed migration as well as regulate autophagy and apoptosis of BMSCs.Therefore,it is speculated that kidney-tonifying medicines regulating BMSCs may be one of its mechanisms for preventing and treating MS.This paper reviewed new insights into the prevention and treatment of MS and other demyelinating diseases using TCM.

关 键 词：多发性硬化 肾主骨生髓充脑 骨髓间充质干细胞 补肾中药 髓鞘再生 机制 

分 类 号：R744.51[医药卫生—神经病学与精神病学]