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中医药通过调控NF-κB信号通路治疗特发性肺纤维化的研究进展
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Abstract:
特发性肺纤维化(idiopathic pulmonary fibrosis, IPF)是一种原因不明确的慢性、进行性、纤维化性和致命性的呼吸系统疾病。由于其发病原因复杂、致死率高，严重影响患者的身心健康。目前IPF的治疗手段十分有限，临床效果不佳，对于生存率和生活质量未能得到明显改善，且易出现不良反应，因此针对IPF尚无理想的治疗方案。NF-κB是细胞内信号转导的主要通路，现代研究发现，NF-κB被视为IPF的主要调节通路，对于开发新的IPF策略具有重要意义。近年来，中药凭借着多成分、多靶点、多通路、不良反应小等优势在抗IPF中得到广泛认可。现已有大量研究表明，中药单体和中药复方可通过干预NF-κB信号通路调控炎症反应、氧化应激、细胞周期、自噬、凋亡以及血管生成等方面，抑制肺泡上皮细胞的转化、凋亡以及成纤维细胞的增殖、血管新生，促进成纤维细胞自噬、凋亡，从而抑制IPF进展，达到抗IPF的治疗效果。故本文从NF-κB信号通路调控IPF的作用机制及中药基于该通路治疗IPF的研究进行综述，以期为今后中药抗IPF的发展及新药研发提供参考。
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrotic and fatal respiratory disease of unknown cause. Due to its complex pathogenesis and high mortality rate, it seriously affects the physical and mental health of patients. At present, the treatment of IPF is very limited, the clinical effect is not good, the survival rate and quality of life can not be significantly improved, and is prone to adverse reactions, so there is no ideal treatment for IPF. NF-κB is the main pathway of intracellular signal transduction. Modern studies have found that NF-κB is regarded as the main regulatory pathway of IPF, which is of great significance for the development of new strategies for IPF. In recent years, traditional Chinese medicine (TCM) has been widely recognized in the treatment of IPF due to its advantages of multi-component, multi-target, multi-pathway and small adverse reactions. A large number of studies have shown that traditional Chinese medicine monomers and compounds can regulate inflammatory response, oxidative stress, cell cycle, autophagy, apoptosis and angiogenesis by interfering with NF-κB signaling pathway, inhibit the transformation and apoptosis of alveolar epithelial cells, proliferation and angiogenesis of fibroblasts, and promote autophagy and apoptosis of fibroblasts. Thus, it can inhibit the progression of IPF and achieve the therapeutic effect of anti-IPF. Therefore, this article reviews the mechanism of NF-κB signaling pathway in the regulation of IPF and the research of traditional Chinese medicine based on this pathway in the treatment of IPF, in order to provide reference for the development of Chinese medicine against IPF and the research and development of new drugs in the future.
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