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中国临床药理学与治疗学 ›› 2025, Vol. 30 ›› Issue (10): 1417-1428.doi: 10.12092/j.issn.1009-2501.2025.10.014

• 综述与讲座 • 上一篇    下一篇

中药单体靶向阿尔茨海默病相关通路的药理机制研究进展

常承天1,刘志华2,程率芳2,王雪可2,赵倩倩1,郜利婷1   

  1. 1河南中医药大学第二临床医学院,郑州  450002,河南;2河南省中医院(河南中医药大学第二附属医院)脑病科,郑州  450002,河南

  • 收稿日期:2024-10-18 修回日期:2025-02-17 出版日期:2025-10-26 发布日期:2025-10-15
  • 通讯作者: 刘志华,男,主任医师,研究方向:中西医结合防治脑血管疾病研究。 E-mail: hnszyylzh@163.com
  • 作者简介:常承天,男,在读硕士研究生,研究方向:中西医结合防治脑血管疾病研究。 E-mail: 1206937846@qq.com
  • 基金资助:
    河南省中医药科学研究专项课题(2022ZY1065);河南省重点研发与推广专项(科技攻关)(202102311139);2021年第二批河南省卫生健康委国家中医临床研究基地科研专项(2021JDZX2118);河南省科技攻关(252102311014);河南省科技公关(252102310031)

Advances in the pharmacological mechanisms of monomers from Chinese medicine that target pathways involved in Alzheimer's disease

CHANG Chengtian1, LIU Zhihua2, CHENG Shuaifang2, WANG Xueke2, ZHAO Qianqian1, GAO Liting1   

  1. 1The Second Clinical Medical College of Henan University of Traditional Chinese Medicine, Zhengzhou 450002, Henan, China; 2Department of Encephalopathy, Henan Province Hospital of Traditional Chinese Medicine/The Second Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450002, Henan, China
  • Received:2024-10-18 Revised:2025-02-17 Online:2025-10-26 Published:2025-10-15

摘要:

阿尔茨海默病(AD)是一种常见的神经退行性疾病,其病理特征包括β-淀粉样蛋白斑块的沉积、Tau蛋白的磷酸化以及神经元的丧失。随着人口老龄化,AD发病率上升,目前尚无有效治愈方法。中药单体因多样药理作用和低毒副作用受关注。本文详细介绍了Nrf2、NF-κB、PI3K/Akt、MAPK等信号通路在AD发病中的作用机制,以及钩藤碱、丹参酮ⅡA等多种中药单体对这些通路的调控作用及研究进展。如钩藤碱可激活Nrf2减轻氧化应激,丹参酮ⅡA能抑制NF-κB通路减少炎症。尽管中药单体治疗AD有前景,但也面临作用机制未完全明确、药代动力学和生物利用度问题突出、临床研究样本量小且质量参差不齐、质量控制难以及与其他药物相互作用需重视等挑战。

关键词: 中药单体, 阿尔茨海默病, 信号通路, 淫羊藿苷, 黄芩苷 ,   

Abstract:

Alzheimer's disease (AD) is a prevalent neurodegenerative disorder, characterized by the accumulation of beta-amyloid plaques, the phosphorylation of Tau proteins, and neuronal loss. As the global population ages, the incidence of AD is rising, and there is currently no effective cure.Herbal monomers have garnered interest due to their multifaceted pharmacological effects and low toxicity. This paper aims to provide a comprehensive overview of the mechanisms of Nrf2, NF-κB, PI3K/Akt, MAPK and other signalling pathways in the pathogenesis of AD. It also explores the modulation of these pathways by various TCM monomers, such as leptomeningine and tanshinone IIA, and details the research progress to date. For instance, Leptosine has been shown to activate Nrf2, thereby reducing oxidative stress, while Tanshinone IIA has been observed to inhibit the NF-κB pathway, leading to a reduction in inflammation. Notwithstanding the encouraging indications for the treatment of AD with TCM monomers, there are several challenges that must be addressed. Firstly, the precise mechanism of action remains to be fully elucidated. Secondly, there are significant challenges related to pharmacokinetics and bioavailability. Thirdly, the sample size of clinical studies is limited and of variable quality. Fourthly, the quality control process is complex. Finally, interactions with other drugs must be taken into account.

Key words: herbal monomers, Alzheimer's disease, signaling pathways, icariin, baicalin

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