Shergis J L, Di Y M, Zhang A L, Vlahos R, Helliwell R, Ye J M, Xue C C
Traditional and Complementary Medicine Program, School of Health Sciences and Health Innovations Research Institute (HIRi), RMIT University, Bundoora, VIC, Australia.
Lung Health Research Centre, Department of Pharmacology and Therapeutics, The University of Melbourne, Parkville, VIC, Australia.
Complement Ther Med. 2014 Oct;22(5):944-53. doi: 10.1016/j.ctim.2014.08.006. Epub 2014 Aug 20.
Chronic obstructive pulmonary disease (COPD) is a major global health burden and will become the third largest cause of death in the world by 2030. It is currently believed that an exaggerated inflammatory response to inhaled irritants, in particular cigarette smoke, cause progressive airflow limitation. This inflammation, where macrophages, neutrophils and lymphocytes are prominent, leads to oxidative stress, emphysema, airways fibrosis and mucus hypersecretion. COPD responds poorly to current anti-inflammatory treatments including corticosteroids, which produce little or no benefit. Panax ginseng has a long history of use in Chinese medicine for respiratory conditions, including asthma and COPD.
In this perspective we consider the therapeutic potential of Panax ginseng for the treatment of COPD.
Panax ginseng and its compounds, ginsenosides, have reported effects through multiple mechanisms but primarily have anti-inflammatory and anti-oxidative effects. Ginsenosides are functional ligands of glucocorticoid receptors and appear to inhibit kinase phosphorylation including MAPK and ERK1/2, NF-κB transcription factor induction/translocation, and DNA binding. They also inhibit pro-inflammatory mediators, TNF-α, IL-6, IL-8, ROS, and proteases such as MMP-9. Panax ginseng protects against oxidative stress by increasing anti-oxidative enzymes and reducing the production of oxidants.
Given that Panax ginseng and ginsenosides appear to inhibit processes related to COPD pathogenesis, they represent an attractive therapeutic target for the treatment of COPD.
慢性阻塞性肺疾病（COPD）是一项重大的全球健康负担，到2030年将成为世界第三大死因。目前认为，对吸入性刺激物，尤其是香烟烟雾的过度炎症反应会导致进行性气流受限。这种以巨噬细胞、中性粒细胞和淋巴细胞为主的炎症会导致氧化应激、肺气肿、气道纤维化和黏液分泌过多。COPD对包括皮质类固醇在内的当前抗炎治疗反应不佳，这些治疗几乎没有益处或根本没有益处。人参在中医中用于治疗包括哮喘和COPD在内的呼吸道疾病已有很长历史。
在本观点中，我们探讨人参治疗COPD的潜在疗效。
人参及其化合物人参皂苷已被报道通过多种机制发挥作用，但主要具有抗炎和抗氧化作用。人参皂苷是糖皮质激素受体的功能性配体，似乎能抑制激酶磷酸化，包括丝裂原活化蛋白激酶（MAPK）和细胞外信号调节激酶1/2（ERK1/2）、核因子κB（NF-κB）转录因子的诱导/易位以及DNA结合。它们还能抑制促炎介质、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、活性氧（ROS）以及诸如基质金属蛋白酶-9（MMP-9）等蛋白酶。人参通过增加抗氧化酶和减少氧化剂的产生来抵御氧化应激。
鉴于人参和人参皂苷似乎能抑制与COPD发病机制相关的过程，它们是治疗COPD有吸引力的治疗靶点。
