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益母草的发现与治疗应用:从实验室到临床。

Discovery of Leonuri and therapeutical applications: From bench to bedside.

机构信息

State Key Laboratory of Quality Research in Chinese Medicine and School of Pharmacy, Macau University of Science and Technology, Macau, China; Shanghai Key Laboratory of Bioactive Small Molecules, Department of Pharmacology, School of Pharmacy, Fudan University, Shanghai 201203, China.

Shanghai Key Laboratory of Bioactive Small Molecules, Department of Pharmacology, School of Pharmacy, Fudan University, Shanghai 201203, China.

出版信息

Pharmacol Ther. 2018 Aug;188:26-35. doi: 10.1016/j.pharmthera.2018.01.006. Epub 2018 Mar 9.

Abstract

Despite several advances in percutaneous coronary intervention and the discovery of new drugs, the incidence of myocardial infarction and deaths due to cardiovascular diseases (CVD) has not decreased markedly in China. The quality of life is affected seriously, which further results in great social and family burden. Many drugs, from the century-old aspirin to the newly FDA-approved Byvalson, have been proven to be effective in the treatment and prevention of CVD. As clinically reported, those life-saving drugs still have their side effects in regards to the narrow therapeutic indexes influenced by individual genetic variations. Herba Leonuri, also known as Chinese Motherwort, which are naturally present in plants and traditionally are used for the uterotonic action, postpartum blood stasis, breast pain as well as other gynecological disorders in China for thousands of years. Since the last two decades, our group has reported leonurine, a unique alkaloid found in Herba Leonuri, exhibits various bioactivities such as antioxidant, anti-apoptotic effects, free radical scavenging and anti-inflammatory effects, in addition to improving micro-circulation. These bioactivities are related to the underlying mechanisms of ischemic heart diseases and cardiac fibrosis. Pharmacological studies have proven leonurine to be effective in treating CVD in various ways, particularly ischemic heart diseases. Besides the cardio protective effects, which are similar in the central nervous system, more specifically, inhibited mitochondrial reactive oxygen species production together with the restored mitochondrial function and redox state were observed in middle cerebral artery occlusion rats by leonurine treatment, which strongly reveals its neuroprotective effects and carries a therapeutic potential for recovery and prevention of stroke. Based on their mode of action, we propose that leonurine can be developed as drugs to treat ischemic heart diseases. Taking advantage of the most recent findings in pharmacological research including the effects of low toxicity and good pharmacokinetics characteristics, leonurine has a very attractive prospect of clinical application. Our recent promising pharmacological results may be able to eradicate the barrier hindering its sale on market. In sum, from bench to bedside is no longer a long way for leonurine.

摘要

尽管经皮冠状动脉介入治疗取得了一些进展,并且发现了新的药物,但中国的心肌梗死发病率和心血管疾病(CVD)死亡率并没有显著下降。生活质量受到严重影响,这进一步给社会和家庭带来了巨大的负担。从一个世纪前的阿司匹林到最近 FDA 批准的 Byvalson,许多药物已被证明在 CVD 的治疗和预防方面有效。临床报告表明,这些救命药物在治疗上仍存在副作用,因为其治疗指数较窄,受到个体遗传变异的影响。益母草,又名中国益母草,在植物中天然存在,在中国传统上用于治疗子宫收缩、产后血瘀、乳房疼痛以及其他妇科疾病已有数千年的历史。在过去的二十年中,我们的团队报告了益母草中的一种独特生物碱——益母草碱,除了改善微循环外,它还具有抗氧化、抗凋亡、清除自由基和抗炎作用等多种生物活性。这些生物活性与缺血性心脏病和心脏纤维化的潜在机制有关。药理研究已经证明益母草碱可以通过多种方式有效治疗 CVD,特别是缺血性心脏病。除了在中枢神经系统中具有类似的心脏保护作用外,我们还观察到益母草碱治疗大脑中动脉闭塞大鼠可抑制线粒体活性氧的产生,恢复线粒体功能和氧化还原状态,这强烈表明其具有神经保护作用,并具有治疗中风恢复和预防的潜力。基于其作用机制,我们提出益母草碱可以开发为治疗缺血性心脏病的药物。利用药理研究的最新发现,包括低毒性和良好的药代动力学特性的优势,益母草碱具有非常有吸引力的临床应用前景。我们最近有希望的药理研究结果可能能够消除阻碍其上市销售的障碍。总之,益母草碱从实验室到临床的距离不再遥远。

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