基于SIRT1信号通路探究中医药治疗肥胖的研究进展

Research progress in traditional Chinese medicine for obesity treatment based on the sirt1 signaling pathway

关键词:  肥胖  SIRT1信号通路  中医药

Key words:  obesity  SIRT1 signaling pathway  traditional Chinese medicine

摘要:

肥胖是多种代谢性疾病的危险因素，其全球发病率持续攀升，已经成为全球面临的公共卫生问题之一。研究表明，沉默信息调节因子1（SIRT1）主要通过靶向腺苷酸活化蛋白激酶（AMPK）、过氧化物酶体增殖物激活受体γ共激活因子1α（PGC-1α）、过氧化物酶体增殖物激活受体γ（PPARγ）、核因子-κB（NF-κB）和叉头框蛋白O（FOXO）、磷脂酰肌醇3-激酶（PI3K）等下游信号分子调控肥胖的发病机制，包括白色脂肪棕色化、炎症反应、氧化应激、胰岛素抵抗（IR）、糖脂代谢紊乱和肠道菌群失衡等，具有减重和调节代谢紊乱的作用。大量研究发现，中医药能激活SIRT1通路起到抗肥胖作用，具有多靶点、多途径和安全性高的优势，但尚未有相关文献进行系统总结。故文章基于近几年国内外相关研究，深入了解SIRT1通路在肥胖中的作用机制，并总结中药单体、中药复方和针刺治疗通过SIRT1通路治疗肥胖的研究现状，以期为肥胖的临床治疗和靶向药物开发提供理论依据和新思路。

Abstract:

Obesity is a risk factor for various metabolic diseases, and its global prevalence has been rising steadily, emerging as a major public health challenge worldwide. Studies demonstrate that Sirtuins 1(SIRT1) modulates obesity-related pathophysiological mechanisms primarily through targeting downstream signaling molecules including AMP-activated protein kinase(AMPK), Peroxisome proliferator-activated receptor gamma coactivator 1-alpha(PGC-1α), Peroxisome proliferator-activated receptor gamma(PPARγ), Nuclear factor kappa-light-chain-enhancer of activated B cells(NF-κB), Forkhead box O-class proteins(FoxO), and Phosphatidylinositol 3-kinase(PI3K). These regulatory effects encompass white adipose browning, inflammatory responses, oxidative stress balance, insulin resistance(IR) amelioration, glucose and lipid metabolism dysregulation, and gut microbiota homeostasis, collectively contributing to weight reduction and metabolic regulation. Numerous studies have demonstrated that traditional Chinese medicine(TCM) exhibits anti-obesity effects based on SIRT1 pathway activation, characterized by multi-target synergism, pathway diversity, and favorable safety profiles. Nevertheless, systematic reviews elucidating these mechanisms remain scarce. Therefore, based on recent domestic and foreign research, this article aims to gain a deeper understanding of the mechanism of action of the SIRT1 pathway in obesity, and summarize the current research status of using TCM monomers, formulas, and acupuncture to treat obesity through the SIRT1 pathway. The goal is to provide theoretical basis and new ideas for the clinical treatment of obesity and the development of targeted drugs.