Du Yihang, Duan Chenglin, Zhang Xiaohan, Shi Shuqing, Zhu Xueping, Lyu Meng, Wei Yi, Hu Yuanhui
Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Am J Chin Med. 2025;53(3):737-769. doi: 10.1142/S0192415X25500284.
Myocardial ischemia/reperfusion (I/R) injury is characterized by severe inflammation and oxidative stress, and involves the recruitment and activation of immune cells, the release of pro-inflammatory cytokines, and the generation of reactive oxygen species (ROS). The NOD-like receptor protein 3 (NLRP3) inflammasome, a multiprotein complex, is activated when exposed to different danger signals like excessive ROS, changes in ionic flux, and mitochondrial dysfunction. Once the NLRP3 inflammasome is activated, it promotes the maturation and release of pro-inflammatory cytokines such as interleukin-1β and interleukin-18, which contributes to the inflammatory storm in myocardial I/R injury. This inflammatory cascade not only leads to adverse cardiac remodeling but also impairs cardiac function, ultimately exacerbating the clinical outcomes of myocardial infarction. Despite the critical role of the NLRP3 inflammasome in myocardial I/R injury, there is a significant absence of effective therapeutic strategies to address it in clinical practice. In recent years, Chinese herbal medicine has emerged as a promising candidate in the therapeutic landscape of myocardial I/R injury. Chinese herbal medicine exerts its cardioprotective effects through various mechanisms of inhibiting NLRP3 inflammasomes, including enhancing mitochondrial function, reducing ROS generation, inhibiting the release of pro-inflammatory cytokines, and suppressing pyroptosis. This review emphasizes the therapeutic potential of Chinese herbal medicine and its extracts to inhibit NLRP3 inflammasomes in an effort to develop effective treatments for myocardial I/R injury. It likewise summarizes the research results of Chinese herbal medicine interventions for myocardial I/R injury by the mechanism of regulating the NLRP3 inflammasome, providing insights for the development of effective treatments for myocardial I/R injury.
心肌缺血/再灌注（I/R）损伤的特征是严重的炎症和氧化应激，涉及免疫细胞的募集和激活、促炎细胞因子的释放以及活性氧（ROS）的产生。NOD样受体蛋白3（NLRP3）炎性小体是一种多蛋白复合物，当暴露于过量ROS、离子通量变化和线粒体功能障碍等不同危险信号时会被激活。一旦NLRP3炎性小体被激活，它会促进白细胞介素-1β和白细胞介素-18等促炎细胞因子的成熟和释放，这会导致心肌I/R损伤中的炎症风暴。这种炎症级联反应不仅会导致不良的心脏重塑，还会损害心脏功能，最终恶化心肌梗死的临床结局。尽管NLRP3炎性小体在心肌I/R损伤中起关键作用，但在临床实践中却严重缺乏有效的治疗策略来应对它。近年来，中草药已成为心肌I/R损伤治疗领域中一个有前景的候选者。中草药通过多种抑制NLRP3炎性小体的机制发挥其心脏保护作用，包括增强线粒体功能、减少ROS生成、抑制促炎细胞因子的释放以及抑制细胞焦亡。本综述强调了中草药及其提取物在抑制NLRP3炎性小体方面的治疗潜力，以期开发出治疗心肌I/R损伤的有效方法。它同样总结了通过调节NLRP3炎性小体机制进行中草药干预心肌I/R损伤的研究结果，为开发治疗心肌I/R损伤的有效方法提供了思路。
