7种国内上市多糖药物临床应用及作用机制研究进展＊

多糖研究始于20世纪50年代,截至目前在自然界动植物中提取到大量的活性多糖,但因其成分复杂、分子量大,纯化难度大,结构复杂,从而作为药物获得国家批准上市的种类不多。本文总结了目前上市多糖药物的结构、临床应用及其作用机制,包括肝素、硫酸软骨素、黄芪多糖、香菇多糖、灵芝多糖、茯苓多糖、人参多糖等。多糖药物的结构及构效关系是多糖类新药研发的关键问题。目前只有肝素的结构、构效关系可基本阐明。除肝素外,其他多糖药物多有调节免疫,或通过调节免疫发挥抗肿瘤、抗炎作用。多糖药物作用机制复杂。对于多糖作用机制的研究多在细胞因子、细胞信号通路、淋巴细胞等方面。多糖药物的临床作用机制研究仍然缺乏。对这些多糖药物结构、临床应用、作用机制的总结和回顾,可为临床治疗和多糖新药开发提供参考。

Research Progress of Clinical Application and Mechanism of Action of Seven Domestic Listed Polysaccharide Drugs

Polysaccharide research started in the 1950s. Up to now, a large number of active polysaccharides had been extracted from plants and animals in nature. But because of their complex composition, large molecular weight, difficulty of purification and complicated structure, not many kinds of them had been approved as drugs by the national authority. This paper summarized the structure, clinical application and mechanism of action of approved polysaccharide drugs, including heparin, chondroitin sulfate, Radix Astragali seu Hedysari polysaccharide, lentinan, Ganoderma polysaccharide, Poria polysaccharide, Radix Ginseng polysaccharide, etc. The structure and structure-function relationship of polysaccharide drugs are the key issues in the development of new polysaccharide drugs. At present, only the structure and structure-function relationship of heparin can be basically elucidated. In addition to heparin, mostly polysaccharide drugs have immune modulation, or play anti-tumor and anti-inflammatory effects through immune modulation. The mechanism of action of polysaccharide drugs is complex. Studies on the mechanism of polysaccharide are mostly in cytokines, cell signaling pathways, lymphocytes and other aspects. The clinical mechanism of polysaccharide drugs is still lacking. By summarizing and reviewing the structure, clinical application and mechanism of action of these polysaccharide drugs, we can provide reference for clinical treatment and development of new polysaccharide drugs.