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中药治疗自身免疫性甲状腺炎的临床疗效及分子机制。

Clinical efficacy and molecular mechanism of Chinese medicine in the treatment of autoimmune thyroiditis.

机构信息

Institute of Metabolic Diseases, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No.5, North Line Court, Xicheng District, Beijing, 100053, China; Beijing University of Chinese Medicine, No. 11, Beisanhuan East Road, Chaoyang District, Beijing, 100029, China.

Institute of Metabolic Diseases, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No.5, North Line Court, Xicheng District, Beijing, 100053, China; Beijing University of Chinese Medicine, No. 11, Beisanhuan East Road, Chaoyang District, Beijing, 100029, China; Guangdong e-fong Pharmaceutical CO., LTD., Qifeng Industrial Road, Nanhai District, Foshan, 528244, China.

出版信息

J Ethnopharmacol. 2024 Apr 6;323:117689. doi: 10.1016/j.jep.2023.117689. Epub 2023 Dec 29.

Abstract

ETHNOPHARMACOLOGICAL RELEVANCE

Autoimmune Thyroiditis (AIT) is a common refractory autoimmune disease of the endocrine system that may eventually lead to complete loss of thyroid function, with subsequent severe effects on the metabolism. Because of the deficiency in current clinical management of AIT, the need for alternative therapies is highlighted. With its multi-component and multi-target characteristics, Chinese medicine has good potential as an alternative therapy for AIT.

AIM OF THE STUDY

The aim of this study was to systematically summarize the clinical efficacy and safety evaluation of TCM and its active ingredients in the treatment and regulation of AIT. Additionally, we provide an in-depth discussion of the relevant mechanisms and molecular targets to understand the protective effects of traditional Chinese medicine on AIT and explore new ideas for clinical treatment.

MATERIALS AND METHODS

The literature related to "Hashimoto", "autoimmune thyroiditis", "traditional Chinese medicine," and "Chinese herbal medicine" was systematically summarized and reviewed from Web of Science Core Collection, PubMed, CNKI, and other databases. Domestic and international literature were analyzed, compared, and reviewed.

RESULTS

An increasing number of studies have demonstrated that herbal medicines can intervene in immunomodulation, with pharmacological effects such as antibody lowering, anti-inflammatory, anti-apoptotic thyroid follicular cells, regulation of intestinal flora, and regulation of estrogen and progesterone levels. The signaling pathways and molecular targets of the immunomodulatory effects of Chinese herbal medicine for AIT may include Fas/FasL, Caspase, BCL-2, and TLRs/MyD88/NF-κB et al. CONCLUSIONS: The use of Chinese herbs in the treatment and management of AIT is clinically experienced, satisfactory, and safe. Future studies may evaluate the influence of herbal medicines on the occurrence and development of AIT by modulating the interaction between immune factors and conventional signaling pathways.

摘要

民族药理学相关性:自身免疫性甲状腺炎(AIT)是一种常见的内分泌系统难治性自身免疫性疾病,最终可能导致甲状腺功能完全丧失,随后对代谢产生严重影响。由于目前对 AIT 的临床管理存在不足,因此需要替代疗法。由于中药具有多成分、多靶点的特点,因此作为 AIT 的替代疗法具有很好的潜力。

研究目的:本研究旨在系统总结中药及其活性成分在治疗和调节 AIT 中的临床疗效和安全性评价。此外,我们还深入探讨了相关机制和分子靶点,以了解中药对 AIT 的保护作用,并探索新的临床治疗思路。

材料和方法:从 Web of Science 核心合集、PubMed、CNKI 等数据库中系统地总结和回顾了与“桥本氏甲状腺炎”、“自身免疫性甲状腺炎”、“中药”和“中草药”相关的文献。对国内外文献进行了分析、比较和综述。

结果:越来越多的研究表明,草药可以干预免疫调节,具有降低抗体、抗炎、抗凋亡甲状腺滤泡细胞、调节肠道菌群和调节雌激素和孕激素水平等药理作用。中药对 AIT 免疫调节作用的信号通路和分子靶点可能包括 Fas/FasL、Caspase、BCL-2、TLRs/MyD88/NF-κB 等。

结论:中药在 AIT 的治疗和管理中的应用具有临床经验、令人满意和安全性。未来的研究可能会通过调节免疫因子与常规信号通路之间的相互作用,评估草药对 AIT 发生和发展的影响。

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