中医药基于调控ABC转运蛋白干预动脉粥样硬化研究进展

Research Progress of Traditional Chinese Medicine on Intervention in Atherosclerosis Based on Regulation of ABC Transporter

摘要: 动脉粥样硬化(atherosclerosis, AS)是一种能够引发多种严重心脑血管疾病的慢性炎症性疾病，其最主要的病理演化机制是脂代谢失常和炎症反应。脂代谢功能紊乱致使单核巨噬细胞泡沫化，含有大量胆固醇的脂质不断在动脉内膜处产生蓄积，是早期AS的特征性病理表现。三磷酸腺苷结合盒(ATP binding cassette, ABC)转运蛋白家族具有介导胆固醇外流，促进细胞内胆固醇外流，减少胆固醇异常积聚的重要作用，并参与了巨噬细胞脂代谢过程，在AS及相关疾病发生发展与治疗过程中维持了胆固醇逆向转运途径的正常运转。因此，通过促进胆固醇逆向转运的途径以改善巨噬细胞脂代谢抑制其泡沫化是防治AS的重要有效策略之一。传统中医理论认为，形成AS主要的病理因素主要有“痰浊”、“瘀血”、“热毒”三类，由此所确立的健脾化浊法、清热解毒法、活血化瘀法等治疗法则与AS现代研究中对脂代谢障碍、炎症反应等机制的认识是一致的。近年来关于中医药调控ABC转运蛋白抗AS的研究也日益增多，进一步挖掘与AS相关的ABC转运蛋白家族的成员，明确中医药靶向调控ABC转运蛋白抗AS的分子机制，对现代防治AS的基础研究具有深远意义。本文对近年来国内外研究中关于中药组方、单味中药以及中药单体及衍生物通过调控ABC转运蛋白干预AS的研究成果进行了综述。

Abstract: Atherosclerosis (AS) is a chronic inflammatory disease that can cause a variety of serious cardio-vascular and cerebrovascular diseases, and its main pathological evolution mechanism is lipid metabolism disorder and inflammatory response. Dysfunction of lipid metabolism leads to foaming of mononuclear macrophages, and lipids containing a large amount of cholesterol accumulate continuously in the arterial intima, which is a characteristic pathological manifestation of early AS. The adenosine triphosphate binding cassette (ABC) transporter family plays an important role in mediating cholesterol efflux, promoting intracellular cholesterol efflux, and reducing abnormal cholesterol accumulation. It also participates in the lipid metabolism process of macrophages and plays an important role in the occurrence and development of AS and related diseases. The normal operation of the reverse cholesterol transport pathway was maintained during the treatment. Therefore, improving the lipid metabolism of macrophages and inhibiting their foaming by pro-moting the reverse transport of cholesterol is one of the important and effective strategies to pre-vent and treat AS. Traditional Chinese medicine theory believes that the main pathological factors that form AS are mainly three categories: “phlegm turbidity”, “blood stasis” and “heat toxin”. The treatment principle is consistent with the understanding of lipid metabolism disorders, inflam-matory response and other mechanisms in modern AS research. In recent years, the research on the regulation of ABC transporter anti-AS by traditional Chinese medicine has also increased, and the members of the ABC transporter family related to AS are further explored to clarify the molec-ular mechanism of TCM targeting and regulating the anti-AS of ABC transporter. Basic research has far-reaching significance. In this paper, the research results of Chinese medicine prescriptions, single Chinese medicines, and Chinese medicine monomers and derivatives in recent years were reviewed in recent years.