摘要
放射性肺损伤(RILI)是发生于胸部的恶性肿瘤进行放射治疗后出现的常见并发症之一,包括早期出现的放射性肺炎(RIP)和晚期的放射性肺纤维化(RIPF),严重影响患者的生命健康及生活质量,预后不佳。研究发现RILI的发生与多种细胞因子及信号通路有关,该文通过检索近5年的国内外相关文献资料,从细胞因子及信号通路的角度将中药干预RILI的作用研究加以综述,细胞因子包括转换生长因子-β1(TGF-β1)、白细胞介素家族(ILs)、肿瘤坏死因子-α(TNF-α)、血小板源性生长因子(PDGF)、血管内皮生长因子(VEGF)、高迁移率族蛋白B1(HMGB1)等,信号通路包括磷脂酰肌醇3-激酶(PI3K)/蛋白激酶B(Akt)信号通路、丝裂原活化蛋白激酶(MAPK)信号通路、分泌型糖蛋白/β-连环蛋白(Wnt/β-catenin)信号通路、Notch信号受体1(Notch1)/Notch信号配体1(Jagged1)信号通路、核因子E2相关因子2(Nrf2)/抗氧化反应元件(ARE)信号通路等。细胞因子可能通过启动多种下游信号通路参与RILI各阶段的发病,如TGF-β1/Smads信号通路、TGF-β1/VEGF信号通路、TNF-α/核转录因子-κB(NF-κB)信号通路、HMGB1/Toll样受体4(TLR4)信号通路等。近年来许多研究尝试通过下调细胞因子表达、拮抗细胞因子作用或调控信号通路等途径延缓RILI进程。许多中药、中药单体及复方,被证明能抑制某些细胞因子释放和/或调控某些信号通路,降低RILI发生率及减轻其严重程度,取得了良好的治疗效果,越来越引起研究者重视。
Radiation-induced lung injury(RILI),one of the common complications caused by radiotherapy,encompasses two phases:an early phase known as radiation pneumonitis(RP)and a late phase called radiation fibrosis(RF),threatening the life and life quality of patients,with poor prognosis.Accumulating evidence has shown that the occurrence of RILI is related to a variety of cytokines and signaling pathways.This paper summarized the research on the effects of Chinese medicine on RILI from the perspective of cytokines and signaling pathways.Cytokines include transforming growth factor-β1(TGF-β1),interleukins(ILs),tumor necrosis factor-α(TNF-α),platelet-derived growth factor(PDGF),vascular endothelial growth factor(VEGF),and high mobility group box-1(HMGB1).Related signaling pathways are phosphatidylinositol-3-kinase/protein kinase B(PI3K/Akt)signaling pathway,mitogen-activated protein kinase(MAPK)signaling pathway,Wnt/β-catenin signaling pathway,Notch1/Jagged1 signaling pathway,and nuclear factor-E2-related factor2/antioxidant response element(Nrf2/ARE)signaling pathway.Cytokines may interfere with RILI progression by initiating various downstream signaling pathways,such as TGF-β1/Smads signaling pathway,TGF-β1/VEGF signaling pathway,TNF-α/nuclear factor-κB(NF-κB)signaling pathway,and HMGB1/Toll-like receptor 4(TLR4)signaling pathway.In recent years,many scholars have attempted to delay RILI progression by down-regulating the expression of cytokines,antagonizing the effect of cytokines or regulating signaling pathways.It has been verified that many Chinese medicines,Chinese medicine monomers,and compound Chinese medicine prescriptions can inhibit the release of some cytokines or regulate some signaling pathways to reduce the incidence/severity of RILI,with satisfactory therapeutic effects,which have attracted the interest of scholars.
作者
邵佳一
吴勉华
马艳霞
姜泽群
徐泓懿
李沐涵
SHAO Jiayi;WU Mianhua;MA Yanxia;JIANG Zequn;XU Hongyi;LI Muhan(The First School of Clinical Medicine,Nanjing University of Chinese Medicine,Nanjing 210023,China;Jiangsu Collaborative Innovation Center of Traditional Chinese Medicine Prevention and Treatment of Tumor,Nanjing 210023,China;School of Chinese Medicine,School of Integrated Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210023,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2023年第22期244-253,共10页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家自然科学基金青年科学基金项目(81603584)
江苏省中医药管理局江苏省中医药科技发展计划项目(QN2020003)
吴勉华全国名老中医药专家传承工作室(国中医药人教函[2022]75号)
国家中医药管理局第七批全国老中医药专家学术经验继承工作项目(国中医药人教函[2022]76号)。
关键词
放射性肺损伤
细胞因子
信号转导通路
中药干预
radiation-induced lung injury
cytokines
signal transduction pathway
Chinese medicine intervention
