Cui Hemiao, Ji Haixia, Zhang Lu, Zhang Wenwen, Kang Ruixia, Ni Yan, Hao Xuliang
Shanxi Provincial Institute of Traditional Chinese Medicine, Taiyuan, People's Republic of China.
School of Chemical Engineering and Technology, North University of China, Taiyuan, People's Republic of China.
Phytother Res. 2025 Sep;39(9):3903-3923. doi: 10.1002/ptr.70045. Epub 2025 Jul 15.
Cirrhosis is a severe chronic liver disease that typically develops as a result of prolonged hepatic injury and subsequent fibrosis, often driven by immune-mediated mechanisms, inflammatory responses, and oxidative stress. Polysaccharides derived from traditional Chinese medicine (TCM) are prominent constituents of herbal formulations widely employed in the management of cirrhosis and have demonstrated significant efficacy in alleviating clinical symptoms. This review aims to elucidate the potential roles and immunomodulatory mechanisms of TCM polysaccharides in the intervention of cirrhosis. A systematic search was conducted using PubMed and China National Knowledge Infrastructure (CNKI), with keywords including "Traditional Chinese medicine polysaccharides," "liver cirrhosis," and "liver fibrosis," focusing primarily on studies published within the last 5 years. A limited number of foundational older references were also included. After screening for relevance, language (English/Chinese), and full-text availability, 104 articles were analyzed. Signaling pathways such as transforming growth factor-beta1 (TGF-β1)/Smads, mitogen-activated protein kinase (MAPK), nuclear transcription factor-kappaB (NF-κB), interleukin-22 (IL-22)/signal transducer and activator of transcription 3 (STAT3), and wingless-related integration site (Wnt)/β-catenin, as well as various cytokines, have been identified as critical in the progression of cirrhosis. TCM polysaccharides exert their therapeutic effects on cirrhosis through the modulation of immune mechanisms within hepatocytes, thereby inhibiting liver fibrosis, alleviating oxidative stress, and suppressing inflammatory responses. TCM polysaccharides exhibit substantial therapeutic potential for treating cirrhosis through their immunomodulatory effects. These findings indicate that TCM polysaccharides warrant further investigation and clinical translation to fully realize their potential in managing cirrhosis.
肝硬化是一种严重的慢性肝病，通常是长期肝损伤及随后的纤维化所致，常由免疫介导机制、炎症反应和氧化应激驱动。源自中药的多糖是广泛用于肝硬化治疗的草药配方中的主要成分，并且已证明在缓解临床症状方面具有显著疗效。本综述旨在阐明中药多糖在肝硬化干预中的潜在作用和免疫调节机制。使用PubMed和中国知网（CNKI）进行了系统检索，关键词包括“中药多糖”、“肝硬化”和“肝纤维化”，主要关注过去5年内发表的研究。还纳入了少数较早的基础参考文献。在筛选相关性、语言（英语/中文）和全文可用性后，分析了104篇文章。已确定诸如转化生长因子-β1（TGF-β1）/Smads、丝裂原活化蛋白激酶（MAPK）、核转录因子-κB（NF-κB）、白细胞介素-22（IL-22）/信号转导子和转录激活子3（STAT3）以及无翅相关整合位点（Wnt）/β-连环蛋白等信号通路以及各种细胞因子在肝硬化进展中至关重要。中药多糖通过调节肝细胞内的免疫机制对肝硬化发挥治疗作用，从而抑制肝纤维化、减轻氧化应激并抑制炎症反应。中药多糖通过其免疫调节作用在治疗肝硬化方面具有巨大的治疗潜力。这些发现表明，中药多糖值得进一步研究和临床转化，以充分实现其在肝硬化管理中的潜力。
