益气活血开窍类中药及复方调控干细胞促进缺血性脑卒中急性期神经修复的作用. (Chinese)

Effect of traditional Chinese medicine and compounds for supplementing qi and activating blood circulation and inducing resuscitation on regulating stem cells to promote nerve repair of acute ischemic stroke. (English)

BACKGROUND: Endogenous neurogenesis and exogenous stem cell transplantation in the brain show great therapeutic potential for neurological diseases including ischemic stroke, repairing and replacing lost neurons, promoting synaptic remodeling, and inhibiting apoptosis. Traditional Chinese medicine and compound therapy for supplementing qi, activating blood circulation and inducing resuscitation for the treatment of neurological dysfunction after ischemia have certain advantages, targeting nerve repair through a variety of ways, including promoting endogenous neurogenesis and exogenous stem cell survival, proliferation, homing, and inducing neuronal differentiation. OBJECTIVE: To summarize the mechanism of traditional Chinese medicine and compound for supplementing qi, activating blood circulation and inducing resuscitation to promote nerve repair in the acute phase of ischemic stroke, in order to provide a reference for the research and treatment of new drugs in ischemic stroke. METHODS: The articles from CNKI and PubMed databases about traditional Chinese medicine and compound for supplementing qi, activating blood circulation and inducing resuscitation in promotion of nerve repair in the acute phase of ischemic stroke from 2010 to 2022 were searched, with “supplementing qi and activating blood circulation; inducing resuscitation; traditional Chinese medicine (TCM); compounds; ischemic stroke; nerve repair; stem cells” as Chinese and English search terms. After excluding old and duplicate views, the retrieved literature was analyzed and collated, and a total of 124 articles were included for analysis. RESULTS AND CONCLUSION: (1) The definition of stem cells, ischemic stroke and the nerve repair pathway in the acute phase of ischemic stroke were sorted out. (2) The mechanism of action of traditional Chinese medicine and compound for supplementing qi, activating blood circulation and inducing resuscitation to promote nerve repair in the acute phase of ischemic stroke was summarized, mainly including promoting stem cell proliferation, improving stem cell viability and survival rate, promoting nerve cell homing, inducing stem cell differentiation to neurons, inhibiting apoptosis of nerve cells, promoting axon regeneration, regulating angiogenesis and remodeling, improving the level of neurotrophic factors and repairing the integrity of the blood-brain barrier. (3) Through the existing research, the relevant factors and signaling pathways of traditional Chinese medicines and compounds for supplementing qi, activating blood circulation and inducing resuscitation to promote nerve repair in the acute phase of ischemic stroke were summarized, such as Nestin protein expression, DCX protein expression, brain-derived neurotrophic factor, vascular endothelial growth factor and Wnt/β-catenin signaling pathway, Notch signaling pathway, PI3k/ Akt signaling pathway, BDNF/TrkB signaling pathway and ERK/MAPK signaling pathway. It provides a relevant reference for future research on ischemic strokespecific drugs and new clinical treatment methods. [ABSTRACT FROM AUTHOR]

背景: 大脑内源性神经发生和外源性干细胞移植对包括缺血性脑卒中在内的神经系统疾病展现出巨大的治疗潜力, 能够修复和替代丢失的 神经元、促进突触重构、抑制细胞凋亡。益气活血开窍类中药及复方治疗缺血后神经功能障碍具有一定的优势, 通过多种途径靶向神经修 复, 包括促进内源性神经发生及外源性干细胞存活、增殖、归巢、诱导神经元分化。 目的: 综述益气活血开窍类中药及复方促进缺血性脑卒中急性期神经修复的机制, 以期为缺血性脑卒中的新药研究及治疗提供参考。 方法: 检索中国知网和PubMed数据库2010-2022年期间关于益气活血开窍类中药及复方促进缺血性脑卒中急性期神经修复的文献, 以“益 气活血; 开窍; 中药; 复方; 缺血性脑卒中; 神经修复; 干细胞”为中文检索词, 以“supplementing qi and activating blood circulation; inducing resuscitation; traditional Chinese medicine (TCM); compounds; ischemic stroke; nerve repair; stem cells”为英文检索词。排除陈 旧及重复的观点, 将检索到的文献进行分析整理, 共纳入124篇文献进行分析。 结果与结论: ①梳理了干细胞、缺血性脑卒中的定义及缺血性脑卒中急性期神经修复途径。②总结了益气活血开窍类中药及复方促进缺血 性脑卒中急性期神经修复的作用机制, 主要包括促进干细胞增殖、提高干细胞活力及存活率、促进干细胞归巢、诱导干细胞向神经元分 化、抑制神经细胞凋亡、促进轴突再生、调控血管新生及重塑、提高神经营养因子水平及修复血脑屏障完整性。③通过现有的研究总结了 益气活血开窍类中药及复方促进缺血性脑卒中急性期神经修复的相关因子及信号通路, 如Nestin蛋白表达、DCX蛋白表达、脑源性神经营 养因子、血管内皮生长因子及Wnt/β-catenin信号通路、Notch信号通路、PI3k/Akt信号通路、BDNF/TrkB信号通路和ERK/MAPK信号通路等, 为今后缺血性脑卒中特效药物及新的临床治疗方法的研究提供相关参考。 [ABSTRACT FROM AUTHOR]

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