背景:铁死亡是一种铁依赖性脂质过氧化引起的程序性细胞死亡方式,涉及铁超载、脂质过氧化、内质网应激等多种过程.研究发现,铁死亡与心肌缺血再灌注损伤发生发展密切相关,已成为心肌缺血再灌注损伤治疗新的靶点与视点.中药具有多靶点、多层次、不良反应少等优势,在心肌缺血再灌注损伤治疗领域效果显著,影响深远.目的:以铁死亡为切入点,对近年来研究中出现的葛根素、白藜芦醇、川芎嗪、黄芪甲苷Ⅳ等中药单体调控铁死亡抗心肌缺血再灌注损伤的研究进展进行系统阐述和总结.方法:以"铁死亡,心肌损伤,心肌缺血再灌注损伤,信号通路,中药单体,黄酮,多酚类,生物碱,萜类,醌类"为中文检索词,以"Iron death,myocardial injury,myocardial ischemia-reperfusion,signaling pathways,traditional Chinese medicine monomer,flavonoids,polyphenols,alkaloids,terpenes,quinones"为英文检索词,检索中国知网和PubMed数据库2013年1月至2024年6月发表的有关铁死亡与心肌缺血再灌注损伤及中药单体调控机制的文献,排除与研究相关性不高、重复及过时的文献.共检索出1 524篇相关文献,最终纳入76篇文献进行综述分析.结果与结论:①大量动物和细胞实验研究表明,铁死亡在心肌缺血再灌注损伤的发生及进展中发挥重要作用;②中药单体如黄芩苷、白藜芦醇、川芎嗪等可调节铁代谢,减少铁沉积,抑制心肌细胞铁死亡;牡荆素、槲皮素及红景天苷等可改善线粒体功能,提高细胞抗氧化能力,减轻心肌缺血再灌注损伤;③中药单体可通过调节溶质载体家族7成员11/谷胱甘肽过氧化物酶4、二氢乳酸脱氢酶/辅酶Q10、环氧合酶2/前列腺素E2、单磷酸腺苷活化蛋白激酶等铁死亡相关信号通路,对抗心肌缺血再灌注损伤,减少心肌细胞铁死亡.
Traditional Chinese medicine monomers regulate ferroptosis to combat myocardial ischemia-reperfusion injury
BACKGROUND:Ferroptosis is a programmed cell death caused by iron dependent lipid peroxidation,involving various processes such as iron overload,lipid peroxidation,and endoplasmic reticulum stress.Research has found that ferroptosis is closely related to the occurrence and development of myocardial ischemia-reperfusion injury,and has become a new target and perspective for MIRI treatment.Traditional Chinese medicine has advantages such as multi-target,multi-level,and fewer adverse reactions,and has significant effects in the treatment of myocardial ischemia-reperfusion injury,with a far-reaching impact.OBJECTIVE:Taking ferroptosis as the starting point,to systematically elaborate and summarize the research progress in the modulation of ferroptosis against myocardial ischemia-reperfusion injury by monomers of traditional Chinese medicines such as puerarin,resveratrol,ligustrazine,and astragaloside IV in recent years.METHODS:Using the search terms"iron death,myocardial injury,myocardial ischemia-reperfusion injury,signaling pathways,traditional Chinese medicine monomers,flavonoids,polyphenols,alkaloids,terpenes,quinones"in Chinese and English from January 2013 to June 2024,literature retrieval was performed in the CNKI and PubMed respectively for literature related to ferroptosis,myocardial ischemia-reperfusion injury,and the regulatory mechanism of traditional Chinese medicine monomers.Literature that is not highly correlated,repetitive,or outdated was excluded.A total of 1 524 relevant articles were retrieved,and 76 articles were ultimately included for review.RESULTS AND CONCLUSION:Numerous animal and cell experiments have shown that ferroptosis plays an important role in the occurrence and progression of myocardial ischemia-reperfusion injury.Traditional Chinese medicine monomers such as baicalin,resveratrol,and ligustrazine can regulate iron metabolism,reduce iron deposition,and inhibit ferroptosis in myocardial cells.Pectin,quercetin,and salidroside can improve mitochondrial function,enhance cellular antioxidant capacity,and alleviate myocardial ischemia-reperfusion injury.Traditional Chinese medicine monomers can regulate ferroptosis-related signaling pathways,such as solute carrier family 7 member 11/glutathione peroxidase 4,dihydrolactate dehydrogenase/coenzyme Q10,cyclooxygenase 2/prostaglandin E2,and adenosine monophosphate-activated protein kinase,resist myocardial ischemia-reperfusion injury,and reduce ferroptosis in myocardial cells.
ferroptosismyocardial ischemia-reperfusion injurysignaling pathwaytraditional Chinese medicine monomersmechanism of actionengineered tissue construction