人参皂苷在视网膜和视神经退行性疾病中的研究进展

Research Progress on Ginsenosides in Retinal and Optic Nerve Degenerative Diseases

摘要: 视网膜与视神经退行性疾病是中老年人群致盲的主要原因，其共同特点为神经元及其支持细胞的功能衰退与结构退化，发病机制涉及氧化应激、炎症反应、代谢障碍和神经凋亡等多因素。目前临床尚缺乏针对疾病早期和多环节干预的有效药物。人参皂苷是人参中最主要的活性成分，具有抗氧化、抗凋亡、调节代谢、促进神经再生等多重药理活性，近年来在眼科神经退行性疾病中的研究逐渐增多。本文系统总结了人参皂苷在年龄相关性黄斑变性、糖尿病视网膜病变及视神经退行性疾病中的药理作用及机制研究进展。研究发现，不同类型的人参皂苷可通过调控Nrf2、AMPK、Notch、MAPK、SIRT1等关键信号通路，干预多种病理过程。尽管已有丰富的动物实验与细胞研究支持其潜在价值，但其临床转化仍面临标准化不足、生物利用度低及慢病模型缺乏等挑战。未来研究应聚焦机制精细化解析、靶向制剂优化及多中心临床前研究，为其在退行性眼病中的应用提供坚实基础。

Abstract: Retinal and optic nerve degenerative diseases are among the leading causes of blindness in the elderly population. These conditions share common pathological features, including functional decline and structural degeneration of neurons and supporting cells, involving mechanisms such as oxidative stress, inflammatory responses, metabolic dysregulation, and neuronal apoptosis. Currently, effective early-stage and multi-target pharmacological interventions are lacking. Ginsenosides, the major active constituents of Panax ginseng, exhibit multiple pharmacological effects, including antioxidant, anti-apoptotic, metabolic regulatory, and neuroregenerative activities. In recent years, increasing studies have focused on their therapeutic potential in ocular neurodegenerative diseases. This review systematically summarizes the pharmacological effects and underlying mechanisms of ginsenosides in age-related macular degeneration, diabetic retinopathy, and optic nerve degeneration. Evidence indicates that different types of ginsenosides exert protective effects by modulating key signaling pathways, such as Nrf2, AMPK, Notch, MAPK, and SIRT1. Although extensive in vivo and in vitro data support their therapeutic potential, clinical translation remains limited by the lack of standardization, poor ocular bioavailability, and insufficient chronic disease models. Future research should emphasize refined mechanistic studies, optimized targeted delivery systems, and multi-center preclinical evaluations to pave the way for the clinical application of ginsenosides in degenerative eye diseases.