急性胰腺炎与NLRP3炎症小体的关系及中药调控的研究进展
Research Progress on the Relationship between Acute Pancreatitis and the NLRP3 Inflammasome and the Regulatory Effects of Traditional Chinese Medicine
DOI: 10.12677/acrem.2026.143048, PDF,   
作者: 季晓雅*：黑龙江中医药大学研究生院，黑龙江 哈尔滨；张 杨#：黑龙江中医药大学附属第一医院，黑龙江 哈尔滨
关键词: 急性胰腺炎；NLRPB炎症小体；通路；中药；研究进展；Acute Pancreatitis； NLRP3 Inflammasome； Pathway； Traditional Chinese Medicine； Research Progress
摘要: 急性胰腺炎(Acute Pancreatitis, AP)作为一种临床常见的胰腺炎症性疾病，至今其发病机制依旧存在争议。以往研究发现胰腺腺泡细胞坏死和炎症反应与急性胰腺炎的严重程度及预后密切相关，且有众多机制与炎症反应存在相关性。近些年的深入研究发现，NLRP3炎症小体所启动的炎症级联反应与急性胰腺炎的发病机制密切相关。中药多成分、多靶点、多通路的优势，对急性胰腺炎的防治具有重要意义。文章综合近些年对NLRP3炎症小体激活机制的研究以及与该炎症小体相关的急性胰腺炎进展机制的研究，探讨中药通过干预上述机制对急性胰腺炎发挥的调控作用，就急性胰腺炎与NLRP3炎症小体的关系及中药调控的研究进展作一综述。
Abstract: Acute pancreatitis (AP), a clinically common inflammatory disease of the pancreas, continues to have a controversial pathogenesis. Previous studies have found that pancreatic acinar cell necrosis and inflammatory responses are closely related to the severity and prognosis of acute pancreatitis, with numerous mechanisms associated with the inflammatory response. Recent in-depth research has revealed that the inflammatory cascade initiated by the NLRP3 inflammasome is closely linked to the pathogenesis of acute pancreatitis. Traditional Chinese medicine (TCM), with its advantages of multi-component, multi-target, and multi-pathway actions, holds significant importance in the prevention and treatment of acute pancreatitis. This article synthesizes recent research on the activation mechanisms of the NLRP3 inflammasome and the progression mechanisms of acute pancreatitis related to this inflammasome, exploring the regulatory effects of TCM on acute pancreatitis through intervention in these mechanisms. It provides a review of the relationship between acute pancreatitis and the NLRP3 inflammasome, as well as the research progress in TCM regulation.
文章引用：季晓雅, 张杨. 急性胰腺炎与NLRP3炎症小体的关系及中药调控的研究进展[J]. 亚洲急诊医学病例研究, 2026, 14(3): 374-380. https://doi.org/10.12677/acrem.2026.143048

参考文献

[1] Iannuzzi, J.P., King, J.A., Leong, J.H., Quan, J., Windsor, J.W., Tanyingoh, D., et al. (2022) Global Incidence of Acute Pancreatitis Is Increasing over Time: A Systematic Review and Meta-Analysis. Gastroenterology, 162, 122-134.
https://doi.org/10.1053/j.gastro.2021.09.043
[2] 彭凯新, 文礼. 急性胰腺炎的发病机制研究进展及未来展望[J]. 西安交通大学学报(医学版), 2024, 45(2): 167-177.
[3] Hu, J.X., Zhao, C.F., Wang, S.L., Tu, X., Huang, W., Chen, J., et al. (2023) Acute Pancreatitis: A Review of Diagnosis, Severity Prediction and Prognosis Assessment from Imaging Technology, Scoring System and Artificial Intelligence. World Journal of Gastroenterology, 29, 5268-5291.
https://doi.org/10.3748/wjg.v29.i37.5268
[4] Land, W.G. (2023) Role of Damps and Cell Death in Autoimmune Diseases: The Example of Multiple Sclerosis. Genes & Immunity, 24, 57-70.
https://doi.org/10.1038/s41435-023-00198-8
[5] Koenig, A. and Buskiewicz-Koenig, I.A. (2022) Redox Activation of Mitochondrial Damps and the Metabolic Consequences for Development of Autoimmunity. Antioxidants & Redox Signaling, 36, 441-461.
https://doi.org/10.1089/ars.2021.0073
[6] Kelley, N., Jeltema, D., Duan, Y. and He, Y. (2019) The NLRP3 Inflammasome: An Overview of Mechanisms of Activation and Regulation. International Journal of Molecular Sciences, 20, 3328.
https://doi.org/10.3390/ijms20133328
[7] Tourkochristou, E., Aggeletopoulou, I., Konstantakis, C. and Triantos, C. (2019) Role of NLRP3 Inflammasome in Inflammatory Bowel Diseases. World Journal of Gastroenterology, 25, 4796-4804.
https://doi.org/10.3748/wjg.v25.i33.4796
[8] Fu, J. and Wu, H. (2023) Structural Mechanisms of NLRP3 Inflammasome Assembly and Activation. Annual Review of Immunology, 41, 301-316.
https://doi.org/10.1146/annurev-immunol-081022-021207
[9] Chen, Y., Ye, X., Escames, G., Lei, W., Zhang, X., Li, M., et al. (2023) The NLRP3 Inflammasome: Contributions to Inflammation-Related Diseases. Cellular & Molecular Biology Letters, 28, Article No. 51.
https://doi.org/10.1186/s11658-023-00462-9
[10] Elliott, E.I. and Sutterwala, F.S. (2015) Initiation and Perpetuation of NLRP3 Inflammasome Activation and Assembly. Immunological Reviews, 265, 35-52.
https://doi.org/10.1111/imr.12286
[11] de Carvalho Ribeiro, M. and Szabo, G. (2022) Role of the Inflammasome in Liver Disease. Annual Review of Pathology: Mechanisms of Disease, 17, 345-365.
https://doi.org/10.1146/annurev-pathmechdis-032521-102529
[12] Gao, L., Dong, X., Gong, W., Huang, W., Xue, J., Zhu, Q., et al. (2021) Acinar Cell NLRP3 Inflammasome and Gasdermin D (GSDMD) Activation Mediates Pyroptosis and Systemic Inflammation in Acute Pancreatitis. British Journal of Pharmacology, 178, 3533-3552.
https://doi.org/10.1111/bph.15499
[13] Heilig, R., Dick, M.S., Sborgi, L., Meunier, E., Hiller, S. and Broz, P. (2018) The Gasdermin‐D Pore Acts as a Conduit for IL‐1β Secretion in Mice. European Journal of Immunology, 48, 584-592.
https://doi.org/10.1002/eji.201747404
[14] Gurung, P., Anand, P.K., Malireddi, R.K.S., Vande Walle, L., Van Opdenbosch, N., Dillon, C.P., et al. (2014) FADD and Caspase-8 Mediate Priming and Activation of the Canonical and Noncanonical NLRP3 Inflammasomes. The Journal of Immunology, 192, 1835-1846.
https://doi.org/10.4049/jimmunol.1302839
[15] Zhang, J. and Wirtz, S. (2022) Does Pyroptosis Play a Role in Inflammasome-Related Disorders? International Journal of Molecular Sciences, 23, Article 10453.
https://doi.org/10.3390/ijms231810453
[16] Shen, Q., Chen, Y., Shi, J., Pei, C., Chen, S., Huang, S., et al. (2023) Asperuloside Alleviates Lipid Accumulation and Inflammation in HFD-Induced NAFLD via AMPK Signaling Pathway and NLRP3 Inflammasome. European Journal of Pharmacology, 942, Article 175504.
https://doi.org/10.1016/j.ejphar.2023.175504
[17] Gu, M., Chen, Y.J., Feng, Y.R. and Tang, Z. (2024) LanGui Tea, an Herbal Medicine Formula, Protects against Binge Alcohol-Induced Acute Liver Injury by Activating AMPK-NLRP3 Signaling. Chinese Medicine, 19, Article No. 41.
https://doi.org/10.1186/s13020-024-00906-0
[18] Glaubitz, J., Asgarbeik, S., Lange, R., Mazloum, H., Elsheikh, H., Weiss, F.U., et al. (2023) Immune Response Mechanisms in Acute and Chronic Pancreatitis: Strategies for Therapeutic Intervention. Frontiers in Immunology, 14, Article ID: 1279539.
https://doi.org/10.3389/fimmu.2023.1279539
[19] Tschopp, J. and Schroder, K. (2010) NLRP3 Inflammasome Activation: The Convergence of Multiple Signalling Pathways on ROS Production? Nature Reviews Immunology, 10, 210-215.
https://doi.org/10.1038/nri2725
[20] Zhou, J., Zhou, P., Zhang, Y., Wang, G. and Fan, Z. (2021) Signal Pathways and Markers Involved in Acute Lung Injury Induced by Acute Pancreatitis. Disease Markers, 2021, Article ID: 9947047.
https://doi.org/10.1155/2021/9947047
[21] Chen, W., Yuan, C., Lu, Y., Zhu, Q., Ma, X., Xiao, W., et al. (2020) Tanshinone IIA Protects against Acute Pancreatitis in Mice by Inhibiting Oxidative Stress via the Nrf2/ROS Pathway. Oxidative Medicine and Cellular Longevity, 2020, Article ID: 5390482.
https://doi.org/10.1155/2020/5390482
[22] 辛宛铃, 王宁, 梁岑怡, 等. 中医药干预Nrf2/HO-1信号通路治疗急性胰腺炎的研究进展[J]. 中国实验方剂学杂志, 2024, 30(5): 265-271.
[23] 郇义超, 赵佳. 加味大承气汤对急性胰腺炎模型大鼠血清炎症因子及细胞凋亡的影响[J]. 中国中医急症, 2017, 26(7): 1152-1155.
[24] Wen, Y., Han, C., Liu, T., Wang, R., Cai, W., Yang, J., et al. (2020) Chaiqin Chengqi Decoction Alleviates Severity of Acute Pancreatitis via Inhibition of TLR4 and NLRP3 Inflammasome: Identification of Bioactive Ingredients via Pharmacological Sub-Network Analysis and Experimental Validation. Phytomedicine, 79, Article 153328.
https://doi.org/10.1016/j.phymed.2020.153328
[25] 李劼, 程卓安, 马骄阳, 等. 大承气汤通过抑制HMGB1及NLRP3炎症小体治疗重症急性胰腺炎的研究[J]. 上海中医药杂志, 2022, 56(9): 70-75.
[26] 张强, 樊钰莹, 王立伟, 等. 利胆清胰汤通过调节NF-κB信号通路对小鼠急性胰腺炎模型影响的研究[J]. 系统医学, 2023, 8(10): 34-37+54.
[27] 朱慧, 梁国强, 章一凡, 等. 任氏清胰汤联合西药治疗肝胆湿热型急性胰腺炎的疗效及血清NLRP3、IL-1β、IL-18水平的影响[J]. 四川中医, 2023, 41(6): 126-129.
[28] 金岩柏, 邬林泉, 张成雷, 等. 茵陈承气汤对大鼠重症急性胰腺炎NF-κB活性表达的影响[J]. 实用中西医结合临床, 2011, 11(2): 84-85.
[29] 徐娟, 陈卓锋, 王治伟. 姜黄素通过抑制NF-κB信号通路和NLRP3炎性体轴调控大鼠急性胰腺炎的研究[J]. 实用药物与临床, 2020, 23(8): 693-698.
[30] 杨菊, 王加伟, 张照, 等. 大黄素治疗重症急性胰腺炎并发急性肺损伤临床前研究的Meta分析[J]. 中国医院用药评价与分析, 2023, 23(7): 828-833.
[31] 郑梅, 胡文兰, 阴英, 等. 柚皮素减轻重症急性胰腺炎小鼠心肌损伤[J]. 基础医学与临床, 2019, 39(2): 213-217.
[32] 杨勇, 殷红珍, 胡云飞. 丹参提取物改善大鼠重症急性胰腺炎肺损伤模型的ROS-NLRP3炎症小体信号通路机制[J]. 中国药师, 2019, 22(10): 1795-1800.
[33] 阮辉辉, 卫巍, 许永富. 金银花提取物对重症急性胰腺炎肺损伤大鼠ROS-NLRP3炎症小体信号通路的影响[J]. 中国中医急症, 2019, 28(8): 1344-1348+1353.
[34] 江勇, 朱大侠, 刘礼剑, 等. 人参皂苷Rg1对重症急性胰腺炎模型大鼠肺损伤的治疗作用及其机制[J]. 世界科学技术-中医药现代化, 2023, 25(5): 1766-1773.
[35] Shan, Y., Li, J., Zhu, A., Kong, W., Ying, R. and Zhu, W. (2022) Ginsenoside Rg3 Ameliorates Acute Pancreatitis by Activating the Nrf2/HO-1-Mediated Ferroptosis Pathway. International Journal of Molecular Medicine, 50, Article No. 89.
https://doi.org/10.3892/ijmm.2022.5144
[36] 王欣, 周文勇, 孙月. 黄芪总皂苷通过激活Nrf2/HO-1信号通路缓解L-精氨酸诱导的小鼠急性胰腺炎氧化损伤的研究[J]. 现代中药研究与实践, 2022, 36(3): 38-42.
[37] 吴鹏. 三七总皂甙对大鼠急性胰腺炎NLRP3炎症小体活化的影响[D]: [硕士学位论文]. 衡阳: 南华大学, 2021.
[38] Zerem, E., Kurtcehajic, A., Kunosić, S., Zerem Malkočević, D. and Zerem, O. (2023) Current Trends in Acute Pancreatitis: Diagnostic and Therapeutic Challenges. World Journal of Gastroenterology, 29, 2747-2763.
https://doi.org/10.3748/wjg.v29.i18.2747

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