氧化应激途径下中药单体对血管性痴呆的调控机制研究  

Regulation of Vascular Dementia by Traditional Chinese Medicine Monomer through Antioxidant Stress Pathways

作　　者：陈信朝 董新刚[2] CHEN Xinchao;DONG Xingang(School of Rehabilitation Medicine,Hennan University of Traditional Chinese Medicine,Zhengzhou 450046,China;The First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450046,China)

机构地区：[1]河南中医药大学康复医学院,河南郑州450046 [2]河南中医药大学第一附属医院,河南郑州450046

出　　处：《中山大学学报(医学科学版)》2025年第2期221-229,共9页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：河南省中医药科学研究专项课题(2024ZY2068);河南省中医药科学研究专项课题重大专项(2022ZYZD05);第七批全国名老中医药专家学术经验继承工作项目[豫中医函(2022)3号];河南中医药大学科研苗圃工程(MP2024-51)。

摘　　要：血管性痴呆(VD)是一种由脑血管疾病造成的慢性进行性认知障碍,其发病机制复杂,主要包括神经细胞凋亡、氧化应激反应、炎症反应、铁死亡、线粒体损伤等因素导致的脑组织损伤。其中,氧化应激在VD发生发展中起关键作用,其可致自由基积累,破坏细胞结构,且与炎症反应、线粒体损伤、铁死亡、神经细胞凋亡密切相关,共同构成了一个复杂的致病网络,而中药单体在通过调控氧化应激治疗VD有显著效果。本文综述相关研究进展,探讨了氧化应激在VD中的作用机制,其通过Nrf2、LRP3、NF-κB等因子调控炎症反应;通过过量ROS破坏线粒体功能及动力学平衡介导线粒体损伤方面;通过脂质过氧化、铁代谢和谷胱甘肽代谢介导铁死亡;经蛋白质变性、DNA修饰、内质网应激、死亡受体等途径激活凋亡蛋白介导神经细胞凋亡。同时,本文还总结了中药单体通过调控氧化应激及其相关机制治疗VD的途径,如姜黄素通过降低ROS水平,提升抗氧化与抗炎能力;天麻素既能减轻氧化应激介导的线粒体损伤,又能改善能量代谢并抑制铁死亡;石斛多糖能减轻氧化应激,进而抑制铁死亡;雷公藤甲素可增强抗氧化能力,减少细胞凋亡,延缓VD进展,以期为今后中药单体靶向氧化应激治疗VD的实验机制研究及临床应用提供思路。Vascular dementia(VD)is a chronic progressive cognitive impairment caused by cerebrovascular diseases.Its pathogenesis is complex,primarily involving brain tissue damage due to factors such as neuronal apoptosis,oxidative stress response,inflammatory reaction,ferroptosis,and mitochondrial damage.Among these,oxidative stress plays a crucial role in the development of VD.It leads to the accumulation of free radicals,disrupts cellular structures,and is closely related to inflammatory reactions,mitochondrial damage,ferroptosis,and neuronal apoptosis,together forming a complex pathogenic network.In recent years,monomeric compounds from traditional Chinese medicine(TCM)have shown significant therapeutic effects on VD through the regulation of oxidative stress.This article reviews the relevant research progress and explores the mechanisms of oxidative stress in VD.Oxidative stress regulates inflammatory reactions through factors such as Nrf2,NLRP3,and NF-κB;mediates mitochondrial damage by disrupting mitochondrial function and dynamics through excessive reactive oxygen species(ROS);induces ferroptosis through lipid peroxidation,iron metabolism,and glutathione metabolism;and activates apoptotic proteins via pathways such as protein denaturation,DNA modification,endoplasmic reticulum stress,and death receptors,thereby inducing neuronal apoptosis.Additionally,this article summarizes the therapeutic approaches of TCM monomers in treating VD through the regulation of oxidative stress and its related mechanisms.For example,curcumin reduces ROS levels and enhances antioxidant and anti-inflammatory capacities;gastrodin alleviates mitochondrial damage mediated by oxidative stress,improves energy metabolism,and inhibits ferroptosis;dendrobium polysaccharides mitigate oxidative stress and subsequently inhibit ferroptosis;and triptolide enhances antioxidant capacity,reduces cell apoptosis,and slows the progression of VD.It is hoped that this review will provide insights for future experimental mechanism studies and clinical applic

关 键 词：氧化应激 炎症反应 线粒体 铁死亡 神经细胞凋亡 

分 类 号：R34[医药卫生—基础医学]