基于浊邪与铁死亡相关性探析动脉粥样硬化之病机

动脉粥样硬化(AS)作为一种血管退行性病变,是心血管疾病共同的病理基础。铁死亡是一种铁依赖性脂质活性氧积聚的细胞程序性死亡方式。越来越多的研究发现AS的发病机制与铁死亡相关。中医学认为“浊邪”是AS的主要病机,铁死亡与中医学“浊邪”存在一定相关性。本文从铁代谢、脂代谢、氨基酸代谢、三羧酸循环、芬顿反应及铁死亡的主要通路探究中医浊邪产生的机制,以细胞的铁死亡方式具化中医学“浊邪”,分析不同形式的“浊邪”,提出铁蓄积的“瘀浊”以活血化瘀法,脂代谢异常的“脂浊”以健脾化浊法,抗氧化系统异常的“浊邪”以补肾固精等治法抑制铁死亡抗AS,为中医药精准化防治AS提供新视角。

Exploring the pathogenesis of atherosclerosis based on the correlation between turbid pathogens and ferroptosis

Atherosclerosis(AS)as a vascular degenerative lesion is the common pathological basis of cardiovascular diseases.Ferroptosis is a form of programmed cell death by iron-dependent accumulation of lipid reactive oxygen species.A growing number of studies have found that the pathogenesis of AS are related to ferroptosis.According to Chinese medicine,“turbidity” is the main pathogenesis of AS,and there is a correlation between ferroptosis and “turbidity” in Chinese medicine.In this paper,we investigated the mechanism of iron metabolism,lipid metabolism,amino acid metabolism,tricarboxylic acid cycle,Fenton reaction and the main pathways of ferroptosis in Chinese medicine.We propose the treatment of “stagnation” of iron accumulation by activating blood circulation and resolving stasis,“lipid” of abnormal lipid metabolism by strengthening the spleen and resolving turbidity,and “turbidity” of abnormal antioxidant system by tonifying the kidneys and consolidating essence to inhibit iron death against AS.This study provides a new perspective for the precise prevention and treatment of AS in Chinese medicine.