Research Progress in the Regulation of Macrophages by Active Components and Compound Formulas of Chinese Drugs in the Treatment of Lumbar Disc Herniation
Lumbar Disc Herniation(LDH)often results from the invasion of pathogenic wind,cold,dampness,and heat,or from aging-related deficiencies,particularly in the liver and kidneys.It can also be caused by trauma,stagnation of qi and blood and impaired me-ridian circulation.Thus,the pathogenesis generally involves a root deficiency with secondary excess.Treatment should focus on expelling wind,eliminating dampness,dispersing cold,clearing heat,draining dampness,invigorating blood,and unblocking meridians to address the symptoms,while nourishing the liver and kidney,and strengthening the tendons and bones is essential to treat the underlying cause.Macrophage polarization plays a crucial role in the development and progression of LDH,as it can improve the local inflammatory micro-environment and exert analgesic effects,making it a potential therapeutic target for LDH.Macrophage-related signaling pathways in-volved in LDH include the NF-κB signaling pathway,NLRP3 inflammasome signaling pathway,MAPK signaling pathway,and Notch sig-naling pathway.Active components and compound formulas of Chinese drugs can regulate macrophage polarization through multiple pathways,restore the balance between pro-inflammatory and anti-inflammatory factors,and slow the progression of LDH.Active compo-nents extracted from Chinese drugs include aloin from Luhui(Aloe),naringin from Gusuibu(Rhizoma Drynariae),curcumin from Jian-ghuang(Rhizoma Curcumae Longae),magnoloside from Qinjiao(Radix Gentianae Macrophyllae)and Weilingxian(Radix et Rhizoma Clematidis),and berberine from Huanglian(Rhizoma Coptidis).Representative compound formulas include Three Impediments Decoc-tion,Impediment-Removing Decoction,Blood Mansion Stasis-Expelling Decoction,Pubescent Angelica and Mistletoe Decoction.Chinese drugs have the advantages of multiple targets,multiple mechanisms,high efficacy,good quality,affordability,and minimal side effects.Targeted regulation of macrophage polarization to restore the balance of the local inflammatory microenvironment in LDH may be a po-tential future direction for LDH treatment.However,research on the mechanisms of action of active components and compound formulas of Chinese drugs in regulating macrophages in the treatment of LDH is still limited,and there is a lack of in-depth standardized preclini-cal evidence and fundamental experiments.Therefore,future research should focus on strengthening the study of how active components and compound formulas of Chinese drugs regulate macrophage polarization,clarifying the specific mechanisms by which formulas of Chi-nese drugs regulate macrophages in treating LDH,and providing a reliable basis for developing new drugs that delay lumbar disc degen-eration and for better application of TCM.
lumbar disc herniation(LDH)active components of Chinese drugscompound formulas of Chinese drugsmacrophagesmacrophage polarizationsignaling pathwaysThree Impediments DecoctionImpediment-Removing DecoctionBlood Mansion Stasis-Ex-pelling DecoctionPub
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