Li Liu-Cheng, Kan Lian-Di
Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China.
J Ethnopharmacol. 2017 Feb 23;198:45-63. doi: 10.1016/j.jep.2016.12.042. Epub 2016 Dec 28.
Pulmonary fibrosis (PF) is a chronic, debilitating and often lethal lung disorder. Despite the molecular mechanisms of PF are gradually clear with numerous researchers' efforts, few effective drugs have been developed to reverse human PF or even halt the chronic progression to respiratory failure. Traditional Chinese medicine (TCM), the main component of the medical practice used for more than 5000 years especially in China, often exerts wider action spectrum than previously attempted options in treating human diseases. Recent data have shown the anti-fibrotic benefits of the active ingredients from TCM in this field, which may represent an attractive source of the drug discovery against PF.
This review summarizes the pre-clinical and clinical evidence on the benefits of TCM and their active ingredients, and provides a comprehensive information and reliable basis for the exploration of new treatment strategies of botanical drugs in the therapy of PF.
The literature information was obtained from the scientific databases on ethnobotany and ethno medicines (up to Aug 2016), mainly from the Pubmed, Web of Science and CNKI databases, and was to identify the experimental studies on the anti-fibrotic role of the active agents from TCM and the involved mechanisms. The search keywords for such work included: "lung fibrosis" or "pulmonary fibrosis", and "traditional Chinese medicine", "extract" or "herb".
A number of studies have shown that the active agents of single herbs and TCM formulas, particularly the flavonoids, glycosides and alkaloids, exhibit potential benefits against PF, the mechanisms of which appear to involve the regulation of inflammation, oxidant stress, and pro-fibrotic signaling pathways, etc. Besides, the processing methods for discovering TCM in treating PF were prospectively discussed.
These research work have shown the therapeutic benefits of TCM in the treatment of PF. However, more continued researches should be undertaken to clarify the unconfirmed chemical composition and regulatory mechanisms, conduct standard clinical trials, and evaluate the possible side effects. The insights provided in present review will be needed for further exploration of botanical drugs in the development of PF therapy.
肺纤维化(PF)是一种慢性、使人衰弱且往往致命的肺部疾病。尽管经过众多研究人员的努力,PF的分子机制已逐渐明晰,但很少有有效的药物被开发出来用于逆转人类PF,甚至阻止其向呼吸衰竭的慢性进展。传统中医(TCM)作为一种主要在中国应用了5000多年的医学实践,在治疗人类疾病方面往往具有比以往尝试的方法更广泛的作用谱。最近的数据表明,中药活性成分在该领域具有抗纤维化益处,这可能是抗PF药物发现的一个有吸引力的来源。
本综述总结了中药及其活性成分益处的临床前和临床证据,并为探索植物药治疗PF的新治疗策略提供全面信息和可靠依据。
文献信息来自民族植物学和民族医学的科学数据库(截至2016年8月),主要来自PubMed、科学网和中国知网数据库,旨在确定关于中药活性剂抗纤维化作用及其涉及机制的实验研究。此类研究的检索关键词包括:“肺纤维化”或“肺纤维化”,以及“传统中药”、“提取物”或“草药”。
多项研究表明,单味草药和中药复方的活性剂,特别是黄酮类、糖苷类和生物碱类,对PF具有潜在益处,其机制似乎涉及炎症、氧化应激和促纤维化信号通路等的调节。此外,还前瞻性地讨论了发现中药治疗PF的加工方法。
这些研究工作表明了中药在治疗PF方面的治疗益处。然而,应进行更多持续研究以阐明未确认的化学成分和调节机制,开展标准临床试验,并评估可能的副作用。本综述提供的见解对于进一步探索植物药治疗PF的发展是必要的。