浏览全部资源
扫码关注微信
1.山东中医药高等专科学校医学系,山东 烟台 264199
2.山东中医药大学康复医学院,济南 250355
Published:30 March 2023,
Received:09 October 2022,
Revised:19 February 2023,
扫 描 看 全 文
王金凤,黄海量,刘杰等.中药调控Th17/Treg平衡治疗类风湿关节炎的研究现状 Δ[J].中国药房,2023,34(06):763-768.
WANG Jinfeng,HUANG Hailiang,LIU Jie,et al.Research status of traditional Chinese medicine regulating Th17/Treg balance in the treatment of rheumatoid arthritis[J].ZHONGGUO YAOFANG,2023,34(06):763-768.
王金凤,黄海量,刘杰等.中药调控Th17/Treg平衡治疗类风湿关节炎的研究现状 Δ[J].中国药房,2023,34(06):763-768. DOI: 10.6039/j.issn.1001-0408.2023.06.23.
WANG Jinfeng,HUANG Hailiang,LIU Jie,et al.Research status of traditional Chinese medicine regulating Th17/Treg balance in the treatment of rheumatoid arthritis[J].ZHONGGUO YAOFANG,2023,34(06):763-768. DOI: 10.6039/j.issn.1001-0408.2023.06.23.
类风湿关节炎(RA)是一种能引起对称性多关节病变的慢性难治性自身免疫性疾病,其发生发展的关键机制是辅助性T细胞17(Th17)/调节性T细胞(Treg)平衡失调,故重构Th17/Treg平衡可能是RA治疗的新策略。中药治疗RA具有整体性和多靶点、多环节、多途径等显著优势。本文就近5年中药调控Th17/Treg平衡治疗RA的基础与临床研究进行总结后发现,黄酮类、生物碱类和萜类等中药有效成分/部位在调控Th17/Treg平衡方面具有独特优势;中药复方可通过发挥祛风、除湿、化瘀、通络、止痛、散寒、扶正等功效来干预Th17/Treg平衡;中药外治效果明显,可作为临床治疗RA的辅助手段;相关作用机制包括调节炎症因子产生、调控转录因子表达和干预信号通路激活等。但现有研究存在机制研究不深入、临床研究少、中药外治研究有限、缺少联合治疗研究的不足,有待后续研究予以完善。
Rheumatoid arthritis (RA) is a refractory autoimmune disease that can cause symmetrical polyarticular disease. The key mechanism of its occurrence and development is the dysequilibrium of helper T cell 17 (Th17)/regulatory T cell (Treg) balance. Therefore, reconstructing Th17/Treg balance may be a new strategy for the treatment of RA. Traditional Chinese medicine has significant advantages in the treatment of RA such as integrity, multi-target, multi-link and multi-path. This paper summarizes the basic and clinical studies on the regulation of Th17/Treg balance in the treatment of RA by traditional Chinese medicine in the past five years, and finds that the active components/sites of traditional Chinese medicine such as flavonoids, alkaloids and terpenes have unique advantages in the regulation of Th17/Treg balance. The traditional Chinese medicine compound formula interferes with Th17/Treg balance by exerting the effects of dispelling wind, dehumidifying, removing blood stasis, unblocking collaterals, relieving pain, dispersing cold and strengthening health. The effect of external treatment of traditional Chinese medicine is obvious and can be used as a clinical adjuvant therapy for RA; related mechanisms of action include regulating the production of inflammatory factors, regulating the expression of transcription factors and interfering with the activation of signaling pathways. However, the existing research has the shortcomings of insufficient mechanism research, few clinical research, limited external treatment research of traditional Chinese medicine, and lack of combination therapy research, which need to be improved by follow-up research.
类风湿关节炎辅助性T细胞17调节性T细胞中药有效成分/部位中药复方中药外治
helper T cell 17regulatory T cellactive components/sites of traditional Chinese medicinetraditional Chinese medicine compound formulaexternal treatment of traditional Chinese medicine
LIN Y J,ANZAGHE M,SCHÜLKE S. Update on the pathomechanism,diagnosis,and treatment options for rheumatoid arthritis[J]. Cells,2020,9(4):E880.
SCHERER H U,HÄUPL T,BURMESTER G R. The etio-logy of rheumatoid arthritis[J]. J Autoimmun,2020,110:102400.
FIRESTEIN G S,MCINNES I B . Immunopathogenesis of rheumatoid arthritis[J]. Immunity,2017,46(2):183-196.
LEE G R. The balance of Th17 versus Treg cells in autoimmunity[J]. Int J Mol Sci,2018,19(3):730.
SUN J X,LI L,LI L Y,et al. Metallothionein-1 suppresses rheumatoid arthritis pathogenesis by shifting the Th17/Treg balance[J]. Eur J Immunol,2018,48(9):1550-1562.
HARRINGTON L E,HATTON R D,MANGAN P R,et al. Interleukin 17-producing CD4+ effector T cells develop via a lineage distinct from the T helper type 1 and 2 lineages[J]. Nat Immunol,2005,6(11):1123-1132.
YANG P,QIAN F Y,ZHANG M F,et al. Th17 cell pathogenicity and plasticity in rheumatoid arthritis[J]. J Leukoc Biol,2019,106(6):1233-1240.
ZHANG S. The role of transforming growth factor β in T helper 17 differentiation[J]. Immunology,2018,155(1):24-35.
SAKAGUCHI S,SAKAGUCHI N,ASANO M,et al. Immunologic self-tolerance maintained by activated T cells expressing IL-2 receptor alpha-chains(CD25): breakdown of a single mechanism of self-tolerance causes various autoimmune diseases[J]. J Immunol,1995,155(3):1151-1164.
ATTIAS M,AL-AUBODAH T,PICCIRILLO C A. Mechanisms of human Foxp3+ Treg cell development and function in health and disease[J]. Clin Exp Immunol,2019,197(1):36-51.
GRAßHOFF H,COMDÜHR S,MONNE L R,et al. Low-dose IL-2 therapy in autoimmune and rheumatic diseases[J]. Front Immunol,2021,12:648408.
KONDO Y,YOKOSAWA M,KANEKO S,et al. Review:transcriptional regulation of CD4+ T cell differentiation in experimentally induced arthritis and rheumatoid arthritis[J]. Arthritis Rheumatol,2018,70(5):653-661.
LE MENN G,JABŁOŃSKA A,CHEN Z. The effects of post-translational modifications on Th17/Treg cell dif- ferentiation[J]. Biochim Biophys Acta Mol Cell Res,2022,1869(6):119223.
VAN HAMBURG J P,TAS S W. Molecular mechanisms underpinning T helper 17 cell heterogeneity and functions in rheumatoid arthritis[J]. J Autoimmun,2018,87:69-81.
李鑫,蔡雄,刘良. Th17细胞在类风湿关节炎发病机制中的作用研究进展[J]. 中国药理学通报,2020,36(3):309-312.
JIANG Q,YANG G C,LIU Q,et al. Function and role of regulatory T cells in rheumatoid arthritis[J]. Front Immunol,2021,12:626193.
GO E,YOO S J,CHOI S,et al. Peripheral blood from rheumatoid arthritis patients shows decreased Treg CD25 expression and reduced frequency of effector Treg subpopulation[J]. Cells,2021,10(4):801.
LI S T,WANG H X,WU H,et al. Therapeutic effect of exogenous regulatory T cells on collagen-induced arthritis and rheumatoid arthritis[J]. Cell Transplant,2020,29:963689720954134.
GAAFAR T,FARID R. The Th17/Treg imbalance in rheumatoid arthritis and relation to disease activity[J]. J Clin Cell Immunol,2015,6(6):1000381.
ALY TAHA H,HOZAYEN W G,OKASHA A M,et al. Investigating the balance between Th17/Treg cells in rheumatoid arthritis and its association with disease activity[J]. J Child Sci,2019,9(1):e75-e83.
RIYADH MOHSEN E,ALI N H,ALDAOSERI H A. Immunologic parameters for disease activity in rheumatoid arthritis[J]. Arch Razi Inst,2021,76(4):1095-1105.
MIN H K,KIM S,LEE J Y,et al. IL-18 binding protein suppresses IL-17-induced osteoclastogenesis and rectifies type 17 helper T cell/regulatory T cell imbalance in rheumatoid arthritis[J]. J Transl Med,2021,19(1):392.
ZHANG H,YIN L,LU M,et al. Evodiamine attenuates adjuvant-induced arthritis in rats by inhibiting synovial inflammation and restoring the Th17/Treg balance[J]. J Pharm Pharmacol,2020,72(6):798-806.
曹干,王秋艳,张艳丽. 氧化苦参碱对CIA大鼠Treg和Th17细胞的作用[J]. 时珍国医国药,2019,30(4):779-781.
卢嘉微,陈都,张淑芳,等. 雷公藤红素对胶原诱导性关节炎小鼠的免疫作用研究[J]. 南京中医药大学学报,2018,34(5):491-494.
WANG Z H,QIN C,RAN T,et al. Effects of Astragalus glycoprotein on Th17/Treg cells in mice with collagen-induced arthritis[J]. J Biol Regul Homeost Agents,2018,32(4):951-957.
何冶,洪明志,胡盼鑫. 柚皮苷上调miR-21对改善类风湿关节炎大鼠Treg/Th17失衡的研究[J]. 新中医,2020,52(15):11-15.
吴峰淼,叶凯丽,刘曦. 黄芩苷对大鼠胶原诱导性关节炎JAK/STAT3信号通路及Th17/Treg免疫平衡的影响[J]. 中国药师,2020,23(2):246-251.
俞云,时乐,喻斌,等. 栀子苷对类风湿性关节炎大鼠Th17/Treg平衡和局部炎症因子的影响[J]. 南京中医药大学学报,2018,34(5):499-503.
栾仲秋,向月,李秋红,等. 槐米提取物对类风湿关节炎大鼠Th17/Treg细胞平衡的调节作用[J]. 中国医药导报,2019,16(20):25-28.
谭宁,贺守第,关丽,等. 蜂毒肽对胶原诱导关节炎大鼠模型Th17/Treg平衡及炎症的影响[J]. 中国比较医学杂志,2019,29(2):1-6.
DINESH P,RASOOL M. Berberine mitigates IL-21/IL-21R mediated autophagic influx in fibroblast-like synoviocytes and regulates Th17/Treg imbalance in rheumatoid arthritis[J]. Apoptosis,2019,24(7/8):644-661.
宋献美,许波,张欢欢,等. 牛膝总皂苷对类风湿关节炎大鼠Th17/Treg平衡和滑膜组织中IL-2、IL-6、TNF-α的影响[J]. 中医研究,2020,33(3):70-73.
刘明,刘杨,邓颖,等. 飞龙掌血提取物对风寒湿佐剂性关节炎大鼠Th17/Treg平衡的影响[J]. 中药药理与临床,2018,34(3):108-111.
马衍慧,章建峰,刘丽敏. 雷公藤多苷下调miR-146a表达以改善类风湿关节炎患者Th17和Treg细胞数目失衡的机制研究[J]. 全科医学临床与教育,2021,19(8):684-687.
WEI M,SU J Y,MA Q,et al. Erteng tongbi decoction ameliorates collagen-induced arthritis in mice via modula-ting T cell differentiation and cytokines balance[J]. J Ethnopharmacol,2022,286:114928.
HUA D,YANG J,MENG Q H,et al. Soufeng sanjie formula alleviates collagen-induced arthritis in mice by inhi-biting Th17 cell differentiation[J]. Chin Med,2021,16(1):39.
DAI X,YANG D P,BAO J P,et al. Er Miao San,a traditional Chinese herbal formula,attenuates complete Freund’s adjuvant-induced arthritis in rats by regulating Th17/Treg cells[J]. Pharm Biol,2020,58(1):157-164.
YANG P,QIAN F Y,ZHANG M F,et al. Zishen tongluo formula ameliorates collagen-induced arthritis in mice by modulation of Th17/Treg balance[J]. J Ethnopharmacol,2020,250:112428.
陈双双,孙建,朱科达,等. 祛风消炎汤对类风湿关节炎大鼠滑膜组织Th17/Treg细胞转录因子RORγt和Foxp3表达影响的研究[J]. 四川中医,2020,38(3):85-88.
武子英,曹炜,祁鑫,等. 清热活血方对胶原诱导性关节炎大鼠肠道微生态及Th17/Treg平衡的影响[J]. 中国中西医结合杂志,2018,38(6):681-686.
REN X B,ZHANG M Z,ZHANG W L,et al. Yunnan Baiyao ameliorates rheumatoid arthritis in rats by shifting the Th17/Treg cell balance and preventing osteoclast differentiation[J]. Evid Based Complement Alternat Med,2022,2022:3764444.
赵海燕,张鸿婷,郭丹丹,等. 独活寄生汤对肝肾不足寒湿痹阻型类风湿性关节炎Th17/Treg平衡的影响[J]. 西部中医药,2021,34(6):8-12.
董文哲,刘健,端淑杰. 新风胶囊通过调节SOCS1/STAT3/miR326改善类风湿关节炎患者Th17/Treg失衡状态[J]. 免疫学杂志,2018,34(6):499-506.
霍新慧,徐海燕,樊思恩,等. 刺山柑对佐剂型关节炎大鼠Th17/Treg免疫失衡的影响[J]. 西部中医药,2021,34(3):46-49.
YAO X M,WANG Q Y,CHEN C M,et al. Wu-Teng-Gao external treatment improves Th17/Treg balance in rheumatoid arthritis[J]. Evid Based Complement Alternat Med,2022,2022:5105545.
REN S J,LIU H,WANG X T,et al. Acupoint nanocomposite hydrogel for simulation of acupuncture and targeted delivery of triptolide against rheumatoid arthritis[J]. J Nanobiotechnology,2021,19(1):409.
阮玲娟,陈春燕,莫娟芬. 散寒除湿法对寒湿痹阻型类风湿关节炎患者Th17/Treg细胞平衡的影响[J]. 新中医,2021,53(11):80-84.
崔启东,王丽娟.周平安教授诊治类风湿关节炎经验探析[J].光明中医,2022,37(12):2129-2131.
刘蔚翔,姜泉.中西医治疗类风湿关节炎的研究进展[J].中华中医药杂志,2022,37(12):7251-7257.
0
Views
6
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution