基于细胞焦亡探讨中药干预缺血性卒中的药理机制研究进展  

Exploring the pharmacological effects of traditional Chinese medicine in ischemic stroke based on cell pyroptosis

作　　者：纳子寒 马妍[2] 白慧梅[2] NA Zihan;MA Yan;BAI Huimei(Graduate School of Tianjin University of Traditional Chinese Medicene,Tianjin 300250,China)

机构地区：[1]天津中医药大学研究生院,300250 [2]天津中医药大学第二附属医院脑病针灸三病区

出　　处：《环球中医药》2025年第3期622-628,共7页Global Traditional Chinese Medicine

基　　金：国家自然科学基金(81804049)。

摘　　要：缺血性卒中(ischemic stroke,IS)是由于脑血流突然中断,局部脑组织缺血、缺氧坏死引发相应神经功能缺损的一类临床综合征,导致了严重的健康和社会问题。细胞焦亡是由半胱氨酸天冬氨酸蛋白酶介导的细胞程序性死亡,参与了IS的诸多环节,在清除有害细胞、平衡能量代谢等方面发挥作用,但过度焦亡也会加重脑组织损伤。本文检索和整理国内外基于焦亡理论探讨中药干预IS的相关文献,结果显示,中药干预IS的药理机制包括抑制核苷酸结合寡聚化结构域样受体蛋白3(nucleotide-binding oligomerization domain-like receptor protein 3,NLRP3)炎症小体介导的细胞焦亡、抑制神经细胞凋亡以增加神经细胞存活;抑制脑微血管内皮细胞焦亡维持血脑屏障稳定;抑制核因子-κB(nuclear factor kappa-B,NF-κB)信号通路、调节小胶质细胞激活来调节免疫炎症反应;抑制核因子E2相关因子2(nuclear factor erythroid 2-related factor 2,Nrf2)信号通路、维持线粒体稳态来减轻氧化应激损伤;抑制腺苷酸活化蛋白激酶(AMP-activated protein kinase,AMPK)信号通路调节能量代谢。本文对以上机制进行总结分析,以期为焦亡理论的深入研究及中药治疗IS提供参考和依据。Ischemic stroke(IS)is a clinical syndrome characterized by the abrupt cessation of cerebral blood flow,resulting in ischemia,hypoxia,and subsequent necrosis of localized brain tissue,thereby contributing to significant health and social challenges.Pyroptosis,a form of programmed cell death mediated by caspase,is implicated in various aspects of IS pathophysiology.Its functions in the elimination of deleterious cells and the regulation of energy metabolism.Nevertheless,excessive pyroptosis can also aggravate brain tissue damage.This paper reviewed both domestic and international literature about the theory of pyroptosis on the intervention of traditional Chinese medicine in IS.This findings indicate that the pharmacological mechanisms underlying traditional Chinese medicine interventions in IS encompass several pathways.These include the inhibition of nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)inflammasome-mediated cell pyroptosis,the suppression of neuronal apoptosis to enhance neuronal survival,and the maintenance of blood-brain barrier integrity through the inhibition of pyroptosis in brain microvascular endothelial cells.Additionally,traditional Chinese medicine can modulate the immune-inflammatory response by inhibiting the nuclear factor kappa-B(NF-κB)signaling pathway and regulating microglial activation.They also mitigate oxidative stress by inhibiting the nuclear factor erythroid 2-related factor 2(Nrf2)signaling pathway and preserving mitochondrial homeostasis.Furthermore,traditional Chinese medicine can regulate energy metabolism by inhibiting the AMP-activated protein kinase(AMPK)signaling pathway.This article summarized and analyzed these mechanisms,thereby providing references for further in-depth studies on pyroptosis theory and the treatment of IS with traditional Chinese medicine.

关 键 词：细胞焦亡 缺血性卒中 脑缺血/再灌注损伤 中医药 综述 

分 类 号：R285[医药卫生—中药学]