中药干预NF-κB信号通路在类风湿关节炎治疗中的作用机制研究
Study on the Mechanism of Action of Chinese Herbal Medicine Intervention in the NF-κB Signaling Pathway for the Treatment of Rheumatoid Arthritis
DOI: 10.12677/acm.2025.1572075, PDF,   
作者: 查宏滨:黑龙江中医药大学研究生院,黑龙江 哈尔滨;姜益常*:黑龙江中医药大学附属第一医院骨伤三科,黑龙江 哈尔滨
关键词: 类风湿关节炎中医药NF-κB信号通路Rheumatoid Arthritis Traditional Chinese Medicine NF-κB Signaling Pathway
摘要: 类风湿关节炎(RA)是一种慢性自身免疫性和炎症疾病,通常累及全身四肢小关节,造成增生性滑膜组织炎症,血管翳的形成,进行性侵蚀关节软骨和软骨下骨,导致关节囊受损、关节功能受限、关节畸形等不可逆性破坏。RA发病机制复杂,涉及多通路多种细胞和分子。核因子κB (NF-κB)信号通路在RA的发病过程中起着关键作用。近年来,中药在RA治疗中的应用日益广泛,其通过多靶点、多途径干预NF-κB信号通路,发挥抗炎、免疫调节和关节保护作用。本文综述了中药干预NF-κB信号通路在RA治疗中的作用机制,探讨了中药单体、复方及活性成分对NF-κB通路的调控作用,为中药治疗RA的现代化和国际化提供理论依据。
Abstract: Rheumatoid arthritis (RA) is a chronic autoimmune and inflammatory disease that typically affects the small joints of the limbs, leading to proliferative synovial tissue inflammation, pannus formation, and progressive erosion of articular cartilage and subchondral bone. These pathological changes result in irreversible damage, including joint capsule impairment, restricted joint function, and joint deformities. The pathogenesis of RA is complex, involving multiple pathways, cells, and molecules. The nuclear factor kappa B (NF-κB) signaling pathway plays a critical role in the development of RA. In recent years, traditional Chinese medicine (TCM) has been increasingly applied in RA treatment, exerting anti-inflammatory, immunomodulatory, and joint-protective effects by targeting the NF-κB signaling pathway through multiple mechanisms. This review summarizes the mechanisms by which TCM intervenes in the NF-κB pathway for RA treatment, exploring the regulatory effects of TCM monomers, compound formulations, and active components on the NF-κB pathway. The findings provide a theoretical foundation for the modernization and internationalization of TCM in RA therapy.
文章引用:查宏滨, 姜益常. 中药干预NF-κB信号通路在类风湿关节炎治疗中的作用机制研究[J]. 临床医学进展, 2025, 15(7): 936-943. https://doi.org/10.12677/acm.2025.1572075

参考文献

[1] Aletaha, D. and Smolen, J.S. (2018) Diagnosis and Management of Rheumatoid Arthritis: A Review. JAMA, 320, 1360-1372. [Google Scholar] [CrossRef] [PubMed]
[2] 雷翔, 高春升, 田逸群. 尪痹片联合甲氨蝶呤片治疗类风湿关节炎患者的药物经济学评价[J]. 中国药物经济学, 2020, 15(11): 5-9, 18.
[3] Song, X., Wang, Y., Li, M., Duan, X., Li, H. and Zeng, X. (2021) Chinese Registry of Rheumatoid Arthritis: IV. Correlation and Consistency of Rheumatoid Arthritis Disease Activity Indices in China. Chinese Medical Journal, 134, 1465-1470. [Google Scholar] [CrossRef] [PubMed]
[4] 许飞, 李学军. 单味中药提取物防治类风湿性关节炎机制探究[J]. 神经药理学报, 2021, 11(3): 15-19.
[5] Radu, A. and Bungau, S.G. (2021) Management of Rheumatoid Arthritis: An Overview. Cells, 10, Article 2857. [Google Scholar] [CrossRef] [PubMed]
[6] Manou-Stathopoulou, S. and Lewis, M.J. (2021) Diversity of NF-κB Signalling and Inflammatory Heterogeneity in Rheumatic Autoimmune Disease. Seminars in Immunology, 58, Article ID: 101649. [Google Scholar] [CrossRef] [PubMed]
[7] 蔡颜嵘, 李凌倩, 卢芳国. 核因子-κB信号通路在类风湿关节炎患者中的作用[J]. 中国民康医学, 2015, 27(16): 70-72.
[8] Houser, J., Jendruchova, K., Knight, A. and Piskacek, M. (2023) The NFκB Activation Domain Is 14-Amino-Acid-Long Variant of the 9aaTAD. Biochemical Journal, 480, 297-306. [Google Scholar] [CrossRef] [PubMed]
[9] 姜申易, 鲁静. NF-κB在类风湿关节炎中的研究进展[J]. 中国免疫学杂志, 2016, 32(1): 119-122.
[10] Birbach, A., Gold, P., Binder, B.R., Hofer, E., de Martin, R. and Schmid, J.A. (2002) Signaling Molecules of the NF-κB Pathway Shuttle Constitutively between Cytoplasm and Nucleus. Journal of Biological Chemistry, 277, 10842-10851. [Google Scholar] [CrossRef] [PubMed]
[11] Yu, H., Lin, L., Zhang, Z., Zhang, H. and Hu, H. (2020) Targeting NF-κB Pathway for the Therapy of Diseases: Mechanism and Clinical Study. Signal Transduction and Targeted Therapy, 5, Article No. 209. [Google Scholar] [CrossRef] [PubMed]
[12] Sun, S. (2017) The Non-Canonical NF-κB Pathway in Immunity and Inflammation. Nature Reviews Immunology, 17, 545-558. [Google Scholar] [CrossRef] [PubMed]
[13] Ali, M., Yang, F., Jansen, J.A. and Walboomers, X.F. (2019) Lipoxin Suppresses Inflammation via the TLR4/MyD88/NF-κB Pathway in Periodontal Ligament Cells. Oral Diseases, 26, 429-438. [Google Scholar] [CrossRef] [PubMed]
[14] Kollewe, C., Mackensen, A., Neumann, D., Knop, J., Cao, P., Li, S., et al. (2004) Sequential Autophosphorylation Steps in the Interleukin-1 Receptor-Associated Kinase-1 Regulate Its Availability as an Adapter in Interleukin-1 Signaling. Journal of Biological Chemistry, 279, 5227-5236. [Google Scholar] [CrossRef] [PubMed]
[15] 尹卫国, 肖建华. IRAK家族在TLR介导的信号通路中的功能和意义[J]. 中南医学科学杂志, 2012, 40(2): 109-115.
[16] Uno, K. (2014) Novel Role of Toll-Like Receptors in Helicobacter pylori-Induced Gastric Malignancy. World Journal of Gastroenterology, 20, 5244-5251. [Google Scholar] [CrossRef] [PubMed]
[17] Kagan, J.C., Su, T., Horng, T., Chow, A., Akira, S. and Medzhitov, R. (2008) TRAM Couples Endocytosis of Toll-Like Receptor 4 to the Induction of Interferon-β. Nature Immunology, 9, 361-368. [Google Scholar] [CrossRef] [PubMed]
[18] Kale, J., Osterlund, E.J. and Andrews, D.W. (2017) BCL-2 Family Proteins: Changing Partners in the Dance towards Death. Cell Death & Differentiation, 25, 65-80. [Google Scholar] [CrossRef] [PubMed]
[19] Li, L., Wu, W., Huang, W., Hu, G., Yuan, W. and Li, W. (2013) NF-κB RNAi Decreases the Bax/Bcl-2 Ratio and Inhibits TNF-α-Induced Apoptosis in Human Alveolar Epithelial Cells. Inflammation Research, 62, 387-397. [Google Scholar] [CrossRef] [PubMed]
[20] 陈平, 杜小正, 王海东, 等. 从NF-κB/Bcl-2信号通路调控成纤维样滑膜细胞凋亡角度探讨中医药抑制类风湿关节炎滑膜炎症机制的研究进展[J]. 中医研究, 2024, 37(1): 87-91.
[21] 赵佶. 圣济总录[M]. 北京: 中国中医药出版社, 2018.
[22] 赵敏, 马佳荣, 李莉, 等. 类风湿关节炎的中医病因病机及治疗研究进展[J]. 甘肃医药, 2024, 43(12): 1057-1060.
[23] 刘颖. 丹参酮-IIA促进类风湿关节炎滑膜成纤维细胞凋亡的作用及机制[D]: [硕士学位论文]. 大连: 大连医科大学, 2019.
[24] 孟如丹, 胡张捷, 毛强. 丹参酮IIA抑制PI3K/AKT/NF-κB通路对炎性软骨细胞的保护作用[J]. 中国现代应用药学, 2021, 38(10): 1166-1173.
[25] 张玉琴. 龙须藤抗类风湿关节炎的药效物质基础及作用机制研究[D]: [硕士学位论文]. 福州: 福建中医药大学, 2013.
[26] Jiang, H., Yu, H., Zheng, S., Wang, X., Hou, A., Kuang, H., et al. (2022) Effect of Xanthii Fructus Alcohol Extract on Proliferation and Apoptosis of HFLS-RA and Its Mechanism. Medicine, 101, e32541. [Google Scholar] [CrossRef] [PubMed]
[27] Jiao, D., Liu, Y., Hou, T., Xu, H., Wang, X., Shi, Q., et al. (2022) Notoginsenoside R1 (NG-R1) Promoted Lymphatic Drainage Function to Ameliorating Rheumatoid Arthritis in TNF-Tg Mice by Suppressing NF-κB Signaling Pathway. Frontiers in Pharmacology, 12, Article 730579. [Google Scholar] [CrossRef] [PubMed]
[28] Huang, Y., Wang, H., Chen, Z., Wang, Y., Qin, K., Huang, Y., et al. (2019) Efficacy and Safety of Total Glucosides of Paeony Combined with Methotrexate and Leflunomide for Active Rheumatoid Arthritis: A Meta-Analysis. Drug Design, Development and Therapy, 13, 1969-1984. [Google Scholar] [CrossRef] [PubMed]
[29] 马运锋, 韩小飞, 苏国磊, 等. 白芍总苷对类风湿性关节炎滑膜细胞增殖、凋亡和炎性因子的影响[J]. 沈阳药科大学学报, 2022, 39(6): 677-683.
[30] Wu, Z., Xiang, Y., Zhu, X., Shi, X., Chen, S., Wan, X., et al. (2022) Icariin Represses the Inflammatory Responses and Survival of Rheumatoid Arthritis Fibroblast-Like Synoviocytes by Regulating the Trib1/Tlr2/ NF-κB Pathway. International Immunopharmacology, 110, Article ID: 108991. [Google Scholar] [CrossRef] [PubMed]
[31] 王晓菲, 李鹏, 杨玥, 等. 重楼皂苷抗炎、抗氧化及抗肿瘤作用机制研究进展[J]. 药物评价研究, 2023, 46(12): 2699-2708.
[32] Wang, Q., Zhou, X., Zhao, Y., Xiao, J., Lu, Y., Shi, Q., et al. (2018) Polyphyllin I Ameliorates Collagen-Induced Arthritis by Suppressing the Inflammation Response in Macrophages through the NF-κB Pathway. Frontiers in Immunology, 9, Article 2091. [Google Scholar] [CrossRef] [PubMed]
[33] 景嵘月. 新痹痛灵对CIA大鼠及RSC-364细胞中HMGB1/NF-κB信号通路的影响研究[D]: [博士学位论文]. 南京: 南京中医药大学, 2015.
[34] 韩隆胤, 王强, 刘明岭, 等. 断藤益母汤调控NF-κB通路减轻LPS 诱导的软骨细胞炎症[J]. 中华中医药学刊, 2021, 39(6): 22-27.
[35] Wei, X., Zhou, R., Chen, Y., Ma, G., Yang, Y., Lu, C., et al. (2022) Systemic Pharmacological Verification of Baixianfeng Decoction Regulating Tnf-Pi3k-Akt-Nf-Κb Pathway in Treating Rheumatoid Arthritis. Bioorganic Chemistry, 119, Article ID: 105519. [Google Scholar] [CrossRef] [PubMed]
[36] Wang, R., Chen, X., Gong, S., Wang, B. and Xu, W. (2024) Interpreting the Pharmacological Mechanisms of Juanbi Recipe on Rheumatoid Arthritis through Network Pharmacology, Molecular Docking. Annals of Joint, 9, Article 23. [Google Scholar] [CrossRef] [PubMed]
[37] 王越业, 常艳, 魏伟. 巨噬细胞异常代谢在类风湿关节炎病理机制中的作用和研究进展[J]. 药学学报, 2020, 55(12): 2827-2833.
[38] 孙建, 陶丽红, 杭煜宇, 等. 温经蠲痹汤对寒湿痹阻证类风湿性关节炎患者的临床疗效[J]. 中成药, 2023, 45(3): 1036-1039.
[39] 杨雪, 李素华, 丛珊, 等. 薏苡仁汤治疗寒湿痹阻型类风湿关节炎有效性和安全性的Meta分析[J]. 风湿病与关节炎, 2022, 11(4): 26-31, 66.
[40] Xu, Q., Kong, H., Ren, S., Meng, F., Liu, R., Jin, H., et al. (2023) Coix Seed Oil Alleviates Synovial Angiogenesis through Suppressing HIF-1α/VEGF-A Signaling Pathways via SIRT1 in Collagen-Induced Arthritis Rats. Chinese Medicine, 18, Article No. 119. [Google Scholar] [CrossRef] [PubMed]
[41] 王岚. 独活寄生汤及有效单体洋川芎内酯Ⅰ调节淋巴回流功能改善类风湿关节炎的机制研究[D]: [硕士学位论文]. 淮南: 安徽理工大学, 2022.
[42] 陈文锦. 独活寄生汤调节NLRP3/NF-κB信号通路治疗膝骨关节炎的机制研究[D]: [博士学位论文]. 南京: 南京中医药大学, 2018.
[43] 赵夜雨. 益气养阴通络中药复方干预类风湿关节炎的疗效及作用机制研究[D]: [博士学位论文]. 沈阳: 辽宁中医药大学, 2019.