Liao Mengqi, Men Ling, Gong Ming, Li Yuanyuan, Wang Yan, Xu Desheng, Luan Jienan, Zhou Hua, Liu Mengnan, Chen Mingtai
Shenzhen Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, 518000, Guangdong, People's Republic of China.
Beijing University of Chinese Medicine Shenzhen Hospital (Longgang), Shenzhen, 518000, Guangdong, People's Republic of China.
Apoptosis. 2025 Sep 12. doi: 10.1007/s10495-025-02178-x.
Myocardial ischemia-reperfusion injury (MIRI) has a high incidence and is difficult to cure. Studies have shown that mitophagy is the key mechanism. This review systematically summarizes all documented herbal preparations and bioactive monomers targeting mitophagy for MIRI treatment, which may serve as a valuable reference for future research on herbal medicine-mediated mitophagy regulation. We conducted comprehensive literature searches in PubMed, Embase, Web of Science, and CNKI databases using the keywords "cardiovascular diseases," "mitophagy," "myocardial ischemia-reperfusion injury," "herbal medicine," "mechanism," and "therapeutic" for studies published within the last five years up to July 2025. Studies on herbal medicine interventions unrelated to mitophagy were excluded. Our analysis reveals that mitophagy plays a crucial role in attenuating the detrimental effects of MIRI. Furthermore, herbal medicine demonstrates therapeutic efficacy in maintaining homeostatic balance of mitophagy during MIRI. Herbal medicines can precisely regulate mitophagy via the PTEN-induced putative kinase 1 (PINK1)-parkin pathway, and modulate the expression of BCL2 interacting protein 3 (BNIP3), FUN14 domain-containing protein 1 (FUNDC1), NIP3-like protein X (NIX). Herbal medicines exert protective effects against MIRI through diverse mechanisms and signaling pathways by targeting mitophagy. While mitophagy represents a promising frontier for future cardiovascular research, current herbal medicine applications remain predominantly confined to animal and cellular models, with only limited clinical translation. The findings presented herein are anticipated to provide clinicians and cardiovascular researchers with valuable therapeutic strategies and novel research directions.
心肌缺血再灌注损伤（MIRI）发病率高且难以治愈。研究表明，线粒体自噬是关键机制。本综述系统总结了所有已记录的针对线粒体自噬用于治疗MIRI的草药制剂和生物活性单体，这可能为未来关于草药介导的线粒体自噬调节的研究提供有价值的参考。我们使用关键词“心血管疾病”“线粒体自噬”“心肌缺血再灌注损伤”“草药”“机制”和“治疗”在PubMed、Embase、Web of Science和CNKI数据库中进行了全面的文献检索，以查找截至2025年7月的过去五年内发表的研究。排除了与线粒体自噬无关的草药干预研究。我们的分析表明，线粒体自噬在减轻MIRI的有害影响方面起着关键作用。此外，草药在维持MIRI期间线粒体自噬的稳态平衡方面显示出治疗效果。草药可以通过磷酸酶和张力蛋白同源物（PTEN）诱导的假定激酶1（PINK1）-帕金通路精确调节线粒体自噬，并调节BCL2相互作用蛋白3（BNIP3）、含FUN14结构域蛋白1（FUNDC1）、NIP3样蛋白X（NIX）的表达。草药通过靶向线粒体自噬，通过多种机制和信号通路对MIRI发挥保护作用。虽然线粒体自噬是未来心血管研究的一个有前景的前沿领域，但目前草药的应用主要仍局限于动物和细胞模型，临床转化有限。本文提出的研究结果有望为临床医生和心血管研究人员提供有价值的治疗策略和新的研究方向。
