Zhou Meng'en, Chen Yan, Jin Wenqi, Li Peng, Hu Jie, Guo Xiutian
Department of Anorectal, Shanghai Municipal, Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, P. R. China.
Am J Chin Med. 2024;52(7):2107-2129. doi: 10.1142/S0192415X24500812. Epub 2024 Nov 25.
Intestinal fibrosis, a common complication of inflammatory bowel disease, in particular in Crohn's disease, arises from chronic inflammation, leading to intestinal narrowing, structural damage, and functional impairment that significantly impact patients' quality of life. Current treatment options for intestinal fibrosis are limited, with surgery being the primary intervention. Traditional Chinese Medicine (TCM) has emerged as a promising approach in preventing and treating intestinal fibrosis. However, there is a scarcity of literature summarizing the mechanisms underlying TCM's efficacy in this context. To address this gap, we conducted a comprehensive review, uncovering multiple mechanisms through which TCM mitigates intestinal fibrosis. These mechanisms include immune cell balance regulation, suppression of inflammatory responses, reduction of inflammatory mediators, alleviation of colon tissue damage, restoration of intestinal function, modulation of growth factors to inhibit fibroblast activation, dynamic regulation of TIMPs and MMPs to reduce extracellular matrix deposition, inhibition of epithelial-mesenchymal transition and endothelial-mesenchymal transition, autophagy modulation, maintenance of the intestinal mucosal barrier, prevention of tissue damage by harmful factors, and regulation of cell proliferation and apoptosis. This study aims to bridge existing knowledge gaps by presenting recent evidence supporting the utilization of TCM in both clinical and experimental research settings.
肠道纤维化是炎症性肠病的常见并发症,尤其是在克罗恩病中,它由慢性炎症引发,导致肠道狭窄、结构损伤和功能障碍,严重影响患者的生活质量。目前肠道纤维化的治疗选择有限,手术是主要干预手段。中医药已成为预防和治疗肠道纤维化的一种有前景的方法。然而,缺乏文献总结中医药在此背景下疗效的潜在机制。为填补这一空白,我们进行了全面综述,揭示了中医药减轻肠道纤维化的多种机制。这些机制包括免疫细胞平衡调节、炎症反应抑制、炎症介质减少、结肠组织损伤减轻、肠道功能恢复、生长因子调节以抑制成纤维细胞活化、TIMP和MMP的动态调节以减少细胞外基质沉积、上皮-间质转化和内皮-间质转化抑制、自噬调节、肠黏膜屏障维持、有害因素所致组织损伤预防以及细胞增殖和凋亡调节。本研究旨在通过呈现支持中医药在临床和实验研究中应用的最新证据来弥合现有知识差距。