State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing 210023, PR China.
State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing 210023, PR China.
Pharmacol Res. 2018 Apr;130:438-450. doi: 10.1016/j.phrs.2018.02.020. Epub 2018 Feb 19.
Fructose is a natural monosaccharide broadly used in modern society. Over the past few decades, epidemiological studies have demonstrated that high fructose intake is an etiological factor of metabolic syndrome (MetS). This review highlights research advances on fructose-induced MetS, especially the underlying pathophysiological mechanism as well as pharmacotherapy by traditional Chinese medicine (TCM), using the PubMed, Web of science, China National Knowledge Infrastructure, China Science and Technology Journal and Wanfang Data. This review focuses on de novo lipogenesis (DNL) and uric acid (UA) production, two unique features of fructolysis different from glucose glycolysis. High level of DNL and UA production can result in insulin resistance, the key pathological event in developing MetS, mostly through oxidative stress and inflammation. Some other pathologies like the disturbance in brain and gut microbiota in the development of fructose-induced MetS in the past years, are also discussed. In management of MetS, TCM is an excellent representative in alternative and complementary medicine with a complete theory system and substantial herbal remedies. TCMs against MetS or MetS components, including Chinese patent medicines, TCM compound formulas, single TCM herbs and active compounds of TCM herbs, are reviewed on their effects and molecular mechanisms. TCMs with hypouricemic activity, which specially target fructose-induced MetS, are highlighted. And new technologies and strategies (such as high-throughput assay and systems biology) in this field are further discussed. In summary, fructose-induced MetS is a multifactorial disorder with the underlying complex mechanisms. Current clinical and pre-clinical evidence supports the potential of TCMs in management of MetS. Additionally, TCMs may show some advantages against complex MetS as their holistic feature through multiple target actions. However, further work is needed to confirm the effectivity and safety of TCMs by high-standard clinical trials, clarify the molecular mechanisms, and develop new anti-MetS drugs by development and application of optimized and feasible strategies and methods.
果糖是一种广泛应用于现代社会的天然单糖。在过去的几十年中，流行病学研究表明，高果糖摄入是代谢综合征（MetS）的一个病因。本综述重点介绍了果糖诱导的 MetS 的研究进展，特别是其潜在的病理生理机制以及中药（TCM）的药物治疗，使用了 PubMed、Web of science、中国知网、中国科技期刊数据库和万方数据。本综述重点介绍了从头合成脂肪（DNL）和尿酸（UA）生成这两个不同于葡萄糖糖酵解的果糖分解的独特特征。高水平的 DNL 和 UA 生成可导致胰岛素抵抗，这是 MetS 发展的关键病理事件，主要通过氧化应激和炎症。近年来，在果糖诱导的 MetS 发展过程中，还讨论了其他一些病理学，如大脑和肠道微生物群的紊乱。在 MetS 的管理中，TCM 是替代和补充医学的杰出代表，具有完整的理论体系和大量的草药疗法。综述了针对 MetS 或 MetS 成分的 TCM，包括中药成药、TCM 复方、单味 TCM 草药和 TCM 草药的活性化合物，以及它们的作用和分子机制。重点介绍了具有降尿酸作用的 TCM，专门针对果糖诱导的 MetS。并进一步讨论了该领域的新技术和策略（如高通量测定和系统生物学）。总之，果糖诱导的 MetS 是一种多因素疾病，其潜在机制复杂。目前的临床前和临床证据支持 TCM 在 MetS 管理中的潜力。此外，TCM 可能因其整体特征（通过多靶点作用）而在治疗复杂的 MetS 方面具有一些优势。然而，需要进一步的工作来通过高标准的临床试验确认 TCM 的有效性和安全性，阐明其分子机制，并通过优化和可行的策略和方法的开发和应用来开发新的抗 MetS 药物。
