铁死亡在动脉粥样硬化中的作用及中药干预的研究进展
The Role of Ferroptosis in Atherosclerosis and Research Progress on Traditional Chinese Medicine Intervention
DOI: 10.12677/tcm.2025.1410630, PDF,   
作者: 马 博：黑龙江中医药大学研究生院，黑龙江 哈尔滨；孙 静：黑龙江中医药大学附属第一医院心血管病二科，黑龙江 哈尔滨
关键词: 铁死亡；动脉粥样硬化；中药干预；机制综述；Ferroptosis； Atherosclerosis； Traditional Chinese Medicine Intervention； Mechanism Review
摘要: 铁死亡是近十年来发现的一种非凋亡形式的程序性细胞死亡，其过程与铁过载和脂质过氧化离不开关系。本文综述了铁死亡的核心调控机制，目前主要包括System Xc−GSH-GPX4轴、非GPX4依赖途径(FSP1/CoQ10, DHODH, GCH1)、铁稳态失衡及脂质过氧化物生成。近年研究表明，铁死亡在多种心血管疾病中发挥着重要作用，例如动脉粥样硬化(AS)，心率失常，心肌缺血再灌注损伤等。内皮细胞、巨噬细胞和平滑肌细胞的铁死亡与AS发生和发展呈正相关。本文还总结了多种中药活性成分(如丹参酮IIA、黄芪甲苷IV、芍药醇、小檗碱、黄芩苷等)及复方(如茱萸丸、豁痰解毒通络饮等)通过抑制铁死亡治疗AS的研究进展。本文认为，靶向铁死亡是防治AS的新方式，而中药具有多靶点干预的特性使其在此领域有着巨大的应用前景。
Abstract: Ferroptosis is a form of non-apoptotic programmed cell death discovered in the past decade, and its process is closely related to iron overload and lipid peroxidation. This article reviews the core regulatory mechanisms of ferroptosis, which currently mainly include the System Xc−GSH-GPX4 axis, non-GPX4-dependent pathways (FSP1/CoQ10, DHODH, GCH1), iron homeostasis imbalance, and lipid peroxide production. Recent studies have shown that ferroptosis plays an important role in various cardiovascular diseases, such as atherosclerosis (AS), arrhythmia, and myocardial ischemia-reperfusion injury. The ferroptosis of endothelial cells, macrophages, and smooth muscle cells is positively correlated with the occurrence and development of AS. This article also summarizes the research progress of a variety of active ingredients of traditional Chinese medicine (such as tanshinone IIA, astragaloside IV, paeonol, berberine, baicalin, etc.) and compound prescriptions (such as Zhuyu Pill, Huotan Jiedu Tongluo Decoction, etc.) in treating AS by inhibiting ferroptosis. This article holds that targeting ferroptosis is a new approach for the prevention and treatment of AS, and the multi-target intervention characteristic of traditional Chinese medicine endows it with broad application prospects in this field.
文章引用：马博, 孙静. 铁死亡在动脉粥样硬化中的作用及中药干预的研究进展[J]. 中医学, 2025, 14(10): 4349-4359. https://doi.org/10.12677/tcm.2025.1410630

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