基于Nrf2/HO-1信号通路的中药及其有效成分抗心血管疾病作用研究进展

心血管疾病是我国居民死亡的首要原因,因其在遗传背景、发病原因、疾病发展走向等方面存在非常大的个体差异性,目前指南指导下的西医规范化治疗的残存死亡风险率仍然很高。中药具有多靶点、多途径、多层次的独特优势,可有效弥补西药的不足,在心血管疾病的治疗中被广泛应用。氧化应激是导致心血管疾病发生的重要原因之一,核因子E2相关因子2(Nrf2)是该反应的中枢调节者,当其被激活后可向核内转移并启动下游通路信号传导,发挥抗氧化应激作用。作为机体最重要的内源性保护体系之一,Nrf2/血红素加氧酶-1(Nrf2/HO-1)信号通路是Nrf2发挥作用的最经典途径。近年来运用现代分子生物学等方法研究并阐明中药通过调控该通路治疗心血管疾病已取得一定的成果。基于此,本文总结了Nrf2/HO-1信号通路与心血管疾病的关系,并归纳分析了中药有效成分、中药药对有效成分、中药提取物及中药复方调节该信号通路干预心血管疾病的的作用方式及可能机制,以期为抗心血管疾病药物的研发与利用提供理论参考。

Effect of Traditional Chinese Medicine and Its Active Ingredients on Cardiovascular Disease Based on Nrf2/HO-1 Signaling Pathway

Cardiovascular disease is the leading cause of death in China. Due to its great individual differences in genetic background, pathogenesis and disease development trend, the survival risk rate after standardized western medicine treatment under the guidance of the current guidelines remains high. Traditional Chinese medicine(TCM) has unique multiple-target, multiple-pathway and multiple-layer advantages, which can effectively make up for shortcomings of western medicine. Therefore, it has been widely used in the treatment of cardiovascular diseases. Oxidative stress is one of the important causes of cardiovascular diseases. Nuclear factor erythroid-2-related factor 2(Nrf2) is the central regulator of this reaction. When being activated, it can transfer to the nucleus and initiate signaling in the downstream pathway, thus playing an anti-oxidative stress role. As one of the most important endogenous protection systems in the body, the Nrf2/heme oxygenase-1 (Nrf2/HO-1) signaling pathway is the most classical approach for Nrf2 in playing roles. There have been certain achievements in studying and clarifying TCM by regulating this pathway to treat cardiovascular diseases using modern molecular biology and other methods. Based on this, this paper summarized the relationship between Nrf2/HO-1 signaling pathway and cardiovascular diseases, then concluded and analyzed the mechanism and pharmacological effects of TCM and its active ingredients in Nrf2/HO-1 signaling pathway on different cardiovascular diseases, involving active ingredients of TCM, TCM pairs active ingredients, TCM extracts and TCM formula. This paper provides a theoretical reference for the development and utilization of anti-cardiovascular drugs.