Li Sha, Xu Yu, Guo Wei, Chen Feiyu, Zhang Cheng, Tan Hor Yue, Wang Ning, Feng Yibin
School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong.
Front Pharmacol. 2020 Mar 24;11:351. doi: 10.3389/fphar.2020.00351. eCollection 2020.
The dysregulation of hepatic lipid metabolism is one of the hallmarks in many liver diseases including alcoholic liver diseases (ALD) and non-alcoholic fatty liver diseases (NAFLD). Hepatic inflammation, lipoperoxidative stress as well as the imbalance between lipid availability and lipid disposal, are direct causes of liver steatosis. The application of herbal medicines with anti-oxidative stress and lipid-balancing properties has been extensively attempted as pharmaceutical intervention for liver disorders in experimental and clinical studies. Although the molecular mechanisms underlying their hepatoprotective effects warrant further exploration, increasing evidence demonstrated that many herbal medicines are involved in regulating lipid accumulation processes including hepatic lipolytic and lipogenic pathways, such as mitochondrial and peroxisomal β-oxidation, the secretion of very low density lipoprotein (VLDL), the non-esterified fatty acid (NEFA) uptake, and some vital hepatic lipogenic enzymes. Therefore, in this review, the pathways or crucial mediators participated in the dysregulation of hepatic lipid metabolism are systematically summarized, followed by the current evidences and advances in the positive impacts of herbal medicines and natural products on the lipid metabolism pathways are detailed. Furthermore, several herbal formulas, herbs or herbal derivatives, such as Erchen Dection, Danshen, resveratrol, and berberine, which have been extensively studied for their promising potential in mediating lipid metabolism, are particularly highlighted in this review.
肝脏脂质代谢失调是包括酒精性肝病（ALD）和非酒精性脂肪性肝病（NAFLD）在内的许多肝脏疾病的特征之一。肝脏炎症、脂质过氧化应激以及脂质供应与脂质处理之间的失衡，是肝脂肪变性的直接原因。在实验和临床研究中，已广泛尝试应用具有抗氧化应激和脂质平衡特性的草药作为肝脏疾病的药物干预措施。尽管其肝脏保护作用的分子机制有待进一步探索，但越来越多的证据表明，许多草药参与调节脂质积累过程，包括肝脏脂肪分解和脂肪生成途径，如线粒体和过氧化物酶体β-氧化、极低密度脂蛋白（VLDL）的分泌、非酯化脂肪酸（NEFA）的摄取以及一些重要的肝脏脂肪生成酶。因此，在本综述中，系统总结了参与肝脏脂质代谢失调的途径或关键介质，随后详细阐述了草药和天然产物对脂质代谢途径积极影响的当前证据和进展。此外，本综述特别强调了几种草药配方、草药或草药衍生物，如二陈汤、丹参、白藜芦醇和黄连素，它们在调节脂质代谢方面具有广阔前景且已得到广泛研究。
