Liu Ying, Zhang Jing-Tian, Sun Meng, Song Jian, Sun Hai-Ming, Wang Meng-Yang, Wang Chun-Mei, Liu Wei
College of Pharmacy, Beihua University, jilin 132013, China.
College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun 130118, China.
Phytomedicine. 2025 Apr;139:156539. doi: 10.1016/j.phymed.2025.156539. Epub 2025 Feb 17.
The incidence of ulcerative colitis (UC) has been rising rapidly in recent years, and there is currently no effective method to prevent its recurrence. Owing to its long treatment duration, difficulty in treatment, prolonged remission, and high costs, it has attracted global attention. Exploring safe, effective, and sustainable treatment regimens has become an urgent global issue. Traditional Chinese medicine (TCM) has unique advantages such as low cost, low drug resistance, and fewer side effects, and has accumulated rich experience in the treatment of UC.
Ferroptosis, as a new form of non-apoptotic cell death, is characterized by iron homeostatic imbalance and lipid peroxidation in the redox system. Studies have shown that inhibited ferroptosis in intestinal epithelial cells can protect the intestinal mucosa. Targeted intervention in ferroptosis may be a new direction for the treatment of UC.
We conducted a systematic literature search with Google Scholar, PubMed, Web of Science, ScienceDirect and X-mol databases have been utilized to retrieve relevant literature up to October 2024, using keywords included ferroptosis, Inflammatory bowel disease (IBD), UC, Crohn's disease and TCM, Chinese traditional prescription, Chinese medicine extract and active ingredients. The existing literature was comprehensively studied and sorted out.
Currently, UC is mainly treated with drugs, including corticosteroids, amino salicylates, biologics, and immunomodulators, but drug resistance and adverse reactions are common. Increasing evidence suggests that TCM may treat UC by interfering with ferroptosis. Scholars have confirmed that TCM can inhibit ferroptosis, and recent studies have shown that TCM can not only inhibit iron dependent lipid peroxidation in intestinal cells but also enhance the antioxidant and anti-inflammatory abilities of intestinal mucosa, thus playing a role in the treatment of UC. This review explores the relevance of TCM intervention in ferroptosis and the treatment of UC, discusses the possible mechanisms of ferroptosis in UC, and aims to provide a basis for the diagnosis and treatment of UC.
It is revealed that TCM targeted ferroptosis has a good application prospect in the treatment of UC, providing a theoretical basis for elucidating the pathogenesis of UC and the study of TCM targeting ferroptosis regulating lipid metabolism in the treatment of UC, and providing a new perspective for the treatment of IBD in the future.
近年来，溃疡性结肠炎（UC）的发病率迅速上升，目前尚无有效的预防复发方法。由于其治疗周期长、治疗难度大、缓解期延长且费用高昂，已引起全球关注。探索安全、有效且可持续的治疗方案已成为全球紧迫问题。中医具有成本低、耐药性低、副作用少等独特优势，在UC治疗方面积累了丰富经验。
铁死亡作为一种新的非凋亡性细胞死亡形式，其特征在于氧化还原系统中铁稳态失衡和脂质过氧化。研究表明，抑制肠上皮细胞中的铁死亡可保护肠黏膜。对铁死亡进行靶向干预可能是UC治疗的新方向。
我们利用谷歌学术、PubMed、科学网、ScienceDirect和X-mol数据库进行了系统的文献检索，以检索截至2024年10月的相关文献，使用的关键词包括铁死亡、炎症性肠病（IBD）、UC、克罗恩病以及中医、中药方剂、中药提取物和活性成分。对现有文献进行了全面研究和梳理。
目前，UC主要采用药物治疗，包括皮质类固醇、氨基水杨酸类、生物制剂和免疫调节剂，但耐药性和不良反应较为常见。越来越多的证据表明，中医可能通过干扰铁死亡来治疗UC。学者们已证实中医可抑制铁死亡，近期研究表明，中医不仅可抑制肠细胞中铁依赖性脂质过氧化，还可增强肠黏膜的抗氧化和抗炎能力，从而在UC治疗中发挥作用。本综述探讨了中医干预铁死亡与UC治疗的相关性，讨论了UC中铁死亡的可能机制，旨在为UC的诊断和治疗提供依据。
结果表明，中医靶向铁死亡在UC治疗中具有良好的应用前景，为阐明UC发病机制以及中医靶向铁死亡调节脂质代谢治疗UC的研究提供了理论依据，并为未来IBD的治疗提供了新视角。
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