Cardiovascular Research Institute of Traditional Chinese Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China.
Cardiovascular Department of Traditional Chinese Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China.
Drug Des Devel Ther. 2022 Jul 17;16:2305-2323. doi: 10.2147/DDDT.S368836. eCollection 2022.
Atherosclerosis is a chronic inflammatory disease of the artery wall associated with lipid metabolism imbalance and maladaptive immune response, which mediates most cardiovascular events. First-line drugs such as statins and antiplatelet drug aspirin have shown good effects against atherosclerosis but may lead to certain side effects. Thus, the development of new, safer, and less toxic agents for atherosclerosis is urgently needed. Diosgenin and its analogs have gained importance for their efficacy against life-threatening diseases, including cardiovascular, endocrine, nervous system diseases, and cancer. Diosgenin and its analogs are widely found in the rhizomes of , and other species and share similar chemical structures and pharmacological effects. Recent data suggested diosgenin plays an anti-atherosclerosis role through its anti-inflammatory, antioxidant, plasma cholesterol-lowering, anti-proliferation, and anti-thrombotic effects. However, a review of the effects of diosgenin and its natural structure analogs on AS is still lacking. This review summarizes the effects of diosgenin and its analogs on vascular endothelial dysfunction, vascular smooth muscle cell (VSMC) proliferation, migration and calcification, lipid metabolism, and inflammation, and provides a new overview of its anti-atherosclerosis mechanism. Besides, the structures, sources, safety, pharmacokinetic characteristics, and biological availability are introduced to reveal the limitations and challenges of current studies, hoping to provide a theoretical basis for the clinical application of diosgenin and its analogs and provide a new idea for developing new agents for atherosclerosis.
动脉粥样硬化是一种与脂质代谢失衡和适应性免疫反应有关的动脉壁慢性炎症性疾病，它介导了大多数心血管事件。他汀类药物和抗血小板药物阿司匹林等一线药物对动脉粥样硬化显示出良好的效果，但可能导致某些副作用。因此，迫切需要开发新的、更安全、毒性更小的动脉粥样硬化治疗药物。薯蓣皂苷元和其类似物因其对包括心血管、内分泌、神经系统疾病和癌症在内的危及生命的疾病的疗效而受到重视。薯蓣皂苷元和其类似物广泛存在于 、 和其他物种的根茎中，具有相似的化学结构和药理作用。最近的数据表明，薯蓣皂苷元通过其抗炎、抗氧化、降低血浆胆固醇、抗增殖和抗血栓作用发挥抗动脉粥样硬化作用。然而，薯蓣皂苷元和其天然结构类似物对动脉粥样硬化的影响的综述仍然缺乏。本综述总结了薯蓣皂苷元和其类似物对血管内皮功能障碍、血管平滑肌细胞（VSMC）增殖、迁移和钙化、脂质代谢和炎症的影响，为其抗动脉粥样硬化机制提供了新的概述。此外，还介绍了其结构、来源、安全性、药代动力学特征和生物利用度，以揭示当前研究的局限性和挑战，希望为薯蓣皂苷元和其类似物的临床应用提供理论依据，并为开发动脉粥样硬化新药物提供新的思路。
