中药调控NF-κB信号通路干预慢性心力衰竭的进展

Traditional Chinese Medicine Intervenes in Chronic Heart Failure Progression by Regulating NF-κB Signaling Pathway： A Review

摘要:

慢性心力衰竭（CHF）是由原始心肌损伤导致心脏功能或结构改变，引起心脏泵血和（或）充盈功能降低的一种临床综合征。其发病机制复杂，可能涉及心肌纤维化、心肌细胞凋亡和自噬、炎症反应、氧化应激反应、心肌重构等。湖南中医药大学胡志希团队认为CHF的根本病机是心气亏虚，病位在心，与其他脏腑密切相关。因心气亏虚，血行无力，则瘀血阻滞，酿生水湿、痰浊，蕴久成毒；水瘀互结，气滞血瘀，酿痰生毒，机体更虚；虚、瘀、水和毒相互影响与促进，形成恶性循环，缠绵难愈。生理情况下，核转录因子-κB（NF-κB）信号通路功能正常，维持人体的生命活动和免疫反应；病理状态下，NF-κB信号通路失衡，引起炎症反应等。研究表明，中医药可以多途径、多靶点、多效应调控NF-κB信号通路，有效改善CHF的病情发展，已逐渐成为防治该病的研究热点。该课题组以中医理论为指导，通过查阅文献，概述NF-κB通路的激活途径及与其他通路的交互关系；总结中药及有效成分、中药复方和中成药调控NF-κB通路治疗CHF的研究进展。以期阐明中医药调控NF-κB通路治疗CHF的作用机制和靶点，指导CHF的临床治疗和药物研发。

Abstract:

Chronic heart failure （CHF） is a clinical syndrome resulting from damage to the myocardium， leading to changes in the function or structure of the heart and causing reduced pumping and/or filling capacity. Its pathogenesis is complex， potentially involving myocardial fibrosis， apoptosis and autophagy of cardiomyocytes， inflammatory responses， oxidative stress， and myocardial remodeling. Our team believes that the fundamental pathogenesis of CHF is heart-Qi deficiency， with the disease location in the heart， which is closely related to other organs. Due to heart-Qi deficiency， blood circulation weakens， leading to blood stasis， which in turn generates water-dampness and phlegm turbidity that accumulate over time and become toxic. The interaction between water stasis， Qi stagnation， blood stasis， and phlegm toxicity further weakens the body， creating a vicious cycle （deficiency， stasis， water retention， and toxicity） that is difficult to resolve. Under physiological conditions， the nuclear factor-κB （NF-κB） signaling pathway functions normally， maintaining vital activities and immune responses. However， in pathological states， the NF-κB signaling pathway becomes imbalanced， triggering inflammatory responses and other issues. Research has shown that traditional Chinese medicine （TCM） can regulate the NF-κB signaling pathway through multiple pathways， targets， and effects， effectively improving the progression of CHF. As a result， this has become a research hotspot for the prevention and treatment of the disease. Guided by TCM theory， this research group reviewed the literature to summarize the activation pathways of the NF-κB pathway and its interactions with other pathways. Additionally， the group summarized the research progress on the regulation of the NF-κB pathway in the treatment of CHF using Chinese medicines， their active ingredients， Chinese medicine compounds， and Chinese patent medicines. This study is expected to clarify the mechanisms and targets by which TCM treats CHF by regulating the NF-κB pathway， thereby guiding clinical treatment and drug development for CHF.