Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China.
School of Traditional Chinese Medicine, China Pharmaceutical University, 639 Longmian Avenue, Nanjing, Jiangsu, China.
Curr Pharm Des. 2019;25(46):4893-4913. doi: 10.2174/1381612825666191216154224.
Inflammatory bowel disease (IBD) is a chronic, elusive disorder resulting in relapsing inflammation of intestine with incompletely elucidated etiology, whose two representative forms are ulcerative colitis (UC) and Crohn's disease (CD). Accumulating researches have revealed that the individual genetic susceptibility, environmental risk elements, intestinal microbial flora, as well as innate and adaptive immune system are implicated in the pathogenesis and development of IBD. Despite remarkable progression of IBD therapy has been achieved by chemical drugs and biological therapies such as aminosalicylates, corticosteroids, antibiotics, anti-tumor necrosis factor (TNF)-α, anti-integrin agents, etc., healing outcome still cannot be obtained, along with inevitable side effects. Consequently, a variety of researches have focused on exploring new therapies, and found that natural products (NPs) isolated from herbs or plants may serve as promising therapeutic agents for IBD through antiinflammatory, anti-oxidant, anti-fibrotic and anti-apoptotic effects, which implicates the modulation on nucleotide- binding domain (NOD) like receptor protein (NLRP) 3 inflammasome, gut microbiota, intestinal microvascular endothelial cells, intestinal epithelia, immune system, etc. In the present review, we will summarize the research development of IBD pathogenesis and current mainstream therapy, as well as the therapeutic potential and intrinsic mechanisms of NPs in IBD.
炎症性肠病(IBD)是一种慢性、隐匿性疾病,导致肠道反复发作炎症,其病因尚未完全阐明,其两种代表性形式是溃疡性结肠炎(UC)和克罗恩病(CD)。越来越多的研究表明,个体遗传易感性、环境风险因素、肠道微生物菌群以及先天和适应性免疫系统都与 IBD 的发病机制和发展有关。尽管化学药物和生物疗法(如氨基水杨酸盐、皮质类固醇、抗生素、抗肿瘤坏死因子(TNF)-α、抗整合素药物等)在 IBD 治疗方面取得了显著进展,但仍无法获得治愈效果,同时还伴随着不可避免的副作用。因此,各种研究都集中在探索新的治疗方法上,并发现从草药或植物中分离出的天然产物(NPs)可能通过抗炎、抗氧化、抗纤维化和抗细胞凋亡作用,成为治疗 IBD 的有前途的治疗剂,这暗示了核苷酸结合域(NOD)样受体蛋白(NLRP)3 炎性体、肠道微生物群、肠道微血管内皮细胞、肠道上皮细胞、免疫系统等的调节。在本综述中,我们将总结 IBD 发病机制和当前主流治疗方法的研究进展,以及 NPs 在 IBD 中的治疗潜力和内在机制。