基于TLR4信号通路探讨中医药干预心肌缺血再灌注损伤的研究进展

Research progress of traditional Chinese medicine intervention in myocardial ischemia-reperfusion injury based on TLR4 signaling pathway

关键词:  中医药  心肌缺血再灌注损伤  Toll样受体4（TLR4）信号通路  作用机制  研究进展

Key words:  traditional Chinese medicine  myocardial ischemia reperfusion injury  Toll-like receptor 4（TLR4） signaling pathway  mechanism  research progress

摘要:

心肌缺血再灌注损伤（MIRI）是再灌注治疗的并发症之一，其病理机制涉及多因素参与的复杂级联反应。其中，Toll样受体4（TLR4）介导的固有免疫应答通过调控炎症级联反应等病理过程，在MIRI进程中发挥关键作用，其活化可能导致炎症反应加剧和心肌损伤加重。中医药具有多途径、多效应和多靶点的独特优势。大量研究表明，中医药能够通过调控TLR4信号通路，抑制炎症反应，保护心肌细胞，有效干预MIRI的进展。目前尚缺乏对此领域的系统总结，故本文总结了TLR4的结构与功能、TLR4信号通路在MIRI中的作用，并概述了中医药在调节TLR4信号通路治疗MIRI方面的研究进展，以期为MIRI的基础研究和临床新药开发提供理论依据和转化方向。

Abstract:

Myocardial ischemia-reperfusion injury（MIRI）is one of the complications of reperfusion therapy，and its pathological mechanism involves a complex cascade of multifactorial involvement. Among them，the innate immune response mediated by Toll-like receptor 4（TLR4）plays a key role in the MIRI process by regulating pathological processes such as the inflammatory cascade，and its activation may lead to the intensification of inflammatory response and aggravation of myocardial injury. Traditional Chinese medicine（TCM）has the unique advantages of multiple pathways，multiple effects，and multiple targets. A large number of studies have shown that TCM can effectively intervene in the progression of MIRI by regulating the TLR4 signaling pathway，inhibiting inflammatory responses，and protecting cardiomyocytes. Therefore，this article summarizes the structure and function of TLR4，the mechanism of action of the TLR4 signaling pathway in MIRI，and summarizes the research progress of traditional Chinese medicine in regulating the TLR4 signaling pathway in the treatment of MIRI，in order to provide a theoretical basis and translational direction for the basic research and clinical development of new drugs in MIRI.