中药调控Th17/Treg平衡治疗类风湿关节炎的研究现状
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篇名: 中药调控Th17/Treg平衡治疗类风湿关节炎的研究现状
TITLE: Research status of traditional Chinese medicine regulating Th17/Treg balance in the treatment of rheumatoid arthritis
摘要: 类风湿关节炎(RA)是一种能引起对称性多关节病变的慢性难治性自身免疫性疾病,其发生发展的关键机制是辅助性T细胞17(Th17)/调节性T细胞(Treg)平衡失调,故重构Th17/Treg平衡可能是RA治疗的新策略。中药治疗RA具有整体性和多靶点、多环节、多途径等显著优势。本文就近5年中药调控Th17/Treg平衡治疗RA的基础与临床研究进行总结后发现,黄酮类、生物碱类和萜类等中药有效成分/部位在调控Th17/Treg平衡方面具有独特优势;中药复方可通过发挥祛风、除湿、化瘀、通络、止痛、散寒、扶正等功效来干预Th17/Treg平衡;中药外治效果明显,可作为临床治疗RA的辅助手段;相关作用机制包括调节炎症因子产生、调控转录因子表达和干预信号通路激活等。但现有研究存在机制研究不深入、临床研究少、中药外治研究有限、缺少联合治疗研究的不足,有待后续研究予以完善。
ABSTRACT: Rheumatoid arthritis (RA) is a refractory autoimmune disease that can cause symmetrical polyarticular disease. The key mechanism of its occurrence and development is the dysequilibrium of helper T cell 17 (Th17)/regulatory T cell (Treg) balance. Therefore, reconstructing Th17/Treg balance may be a new strategy for the treatment of RA. Traditional Chinese medicine has significant advantages in the treatment of RA such as integrity, multi-target, multi-link and multi-path. This paper summarizes the basic and clinical studies on the regulation of Th17/Treg balance in the treatment of RA by traditional Chinese medicine in the past five years, and finds that the active components/sites of traditional Chinese medicine such as flavonoids, alkaloids and terpenes have unique advantages in the regulation of Th17/Treg balance. The traditional Chinese medicine compound formula interferes with Th17/Treg balance by exerting the effects of dispelling wind, dehumidifying, removing blood stasis, unblocking collaterals, relieving pain, dispersing cold and strengthening health. The effect of external treatment of traditional Chinese medicine is obvious and can be used as a clinical adjuvant therapy for RA; related mechanisms of action include regulating the production of inflammatory factors, regulating the expression of transcription factors and interfering with the activation of signaling pathways. However, the existing research has the shortcomings of insufficient mechanism research, few clinical research, limited external treatment research of traditional Chinese medicine, and lack of combination therapy research, which need to be improved by follow- up research.
期刊: 2023年第34卷第06期
作者: 王金凤;黄海量;刘杰;王枫;刘晓庆;马腾茂
AUTHORS: WANG Jinfeng,HUANG Hailiang,LIU Jie,WANG Feng,LIU Xiaoqing,MA Tengmao
关键字: 类风湿关节炎;辅助性T细胞17;调节性T细胞;中药有效成分/部位;中药复方;中药外治
KEYWORDS: rheumatoid arthritis; helper T cell 17; regulatory T cell; active components/sites of traditional Chinese medicine;
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