Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, Taian 271000, China.
Department of Central Laboratory, The Affiliated Taian City Central Hospital of Qingdao University, Taian 271000, China.
Phytomedicine. 2024 Jan;123:155231. doi: 10.1016/j.phymed.2023.155231. Epub 2023 Nov 19.
The term "vascular cognitive impairment" (VCI) describes various cognitive conditions that include vascular elements. It increases the risk of morbidity and mortality in the elderly population and is the most common cognitive impairment associated with cerebrovascular disease. Understanding the etiology of VCI may aid in identifying approaches to target its possible therapy for the condition. Treatment of VCI has focused on vascular risk factors. There are no authorized conventional therapies available right now. The medications used to treat VCI are solely approved for symptomatic relief and are not intended to prevent or slow the development of VCI.
The function of Chinese medicine in treating VCI has not yet been thoroughly examined. This review evaluates the preclinical and limited clinical evidence to comprehend the "multi-component, multi-target, multi-pathway" mechanism of Traditional Chinese medicine (TCM). It investigates the various multi-omics approaches in the search for the pathological mechanisms of VCI, as well as the new research strategies, in the hopes of supplying supportive evidence for the clinical treatment of VCI.
This review used the Preferred Reporting Items for Preferred reporting items for systematic reviews and meta-analyses (PRISMA) statements. Using integrated bioinformatics and network pharmacology approaches, a thorough evaluation and analysis of 25 preclinical studies published up to July 1, 2023, were conducted to shed light on the mechanisms of TCM for vascular cognitive impairment. The studies for the systematic review were located using the following databases: PubMed, Web of Science, Scopus, Cochrane, and ScienceDirect.
We discovered that the multi-omics analysis approach would hasten the discovery of the role of TCM in the treatment of VCI. It will explore components, compounds, targets, and pathways, slowing the progression of VCI from the perspective of inhibiting oxidative stress, stifling neuroinflammation, increasing cerebral blood flow, and inhibiting iron deposition by a variety of molecular mechanisms, which have significant implications for the treatment of VCI.
TCM is a valuable tool for developing dementia therapies, and further research is needed to determine how TCM components may affect the operation of the neurovascular unit. There are still some limitations, although several research have offered invaluable resources for searching for possible anti-dementia medicines and treatments. To gain new insights into the molecular mechanisms that precisely modulate the key molecules at different levels during pharmacological interventions-a prerequisite for comprehending the mechanism of action and determining the potential therapeutic value of the drugs-further research should employ more standardized experimental methods as well as more sophisticated science and technology. Given the results of this review, we advocate integrating chemical and biological component analysis approaches in future research on VCI to provide a more full and objective assessment of the standard of TCM. With the help of bioinformatics, a multi-omics analysis approach will hasten the discovery of the role of TCM in the treatment of VCI, which has significant implications for the treatment of VCI.
“血管性认知障碍”（VCI）一词描述了各种认知状况，其中包括血管因素。它增加了老年人群的发病率和死亡率风险，是与脑血管疾病相关的最常见的认知障碍。了解 VCI 的病因学可能有助于确定针对其可能治疗方法的方法。VCI 的治疗一直集中在血管危险因素上。目前尚无经授权的常规疗法。用于治疗 VCI 的药物仅获准用于缓解症状，而不是用于预防或减缓 VCI 的发展。
中药治疗 VCI 的作用尚未得到充分研究。本综述评估了临床前和有限的临床证据，以了解中药（TCM）的“多成分、多靶点、多途径”机制。它调查了各种多组学方法，以寻找 VCI 的病理机制，以及新的研究策略，希望为 VCI 的临床治疗提供支持证据。
本综述使用了系统评价和荟萃分析的首选报告项目（PRISMA）声明。使用综合的生物信息学和网络药理学方法，对截至 2023 年 7 月 1 日发表的 25 项临床前研究进行了全面评估和分析，以阐明 TCM 治疗血管性认知障碍的机制。系统评价的研究是通过以下数据库找到的：PubMed、Web of Science、Scopus、Cochrane 和 ScienceDirect。
我们发现，多组学分析方法将加速发现 TCM 在治疗 VCI 中的作用。它将从抑制氧化应激、抑制神经炎症、增加脑血流和抑制铁沉积等多种分子机制的角度探索成分、化合物、靶点和途径，减缓 VCI 的进展，这对 VCI 的治疗具有重要意义。
TCM 是开发痴呆症疗法的有价值工具，需要进一步研究以确定 TCM 成分如何影响神经血管单元的运作。尽管一些研究为寻找可能的抗痴呆药物和治疗方法提供了宝贵的资源，但仍存在一些局限性。为了深入了解在药理学干预过程中精确调节不同水平关键分子的分子机制——这是理解作用机制和确定药物潜在治疗价值的前提——应采用更标准化的实验方法以及更复杂的科学技术进行进一步研究。基于本综述的结果，我们主张在未来的 VCI 研究中整合化学和生物成分分析方法，以更全面和客观地评估 TCM 的标准。借助生物信息学，多组学分析方法将加速发现 TCM 在治疗 VCI 中的作用，这对 VCI 的治疗具有重要意义。
