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中华临床医师杂志(电子版) ›› 2024, Vol. 18 ›› Issue (09) : 853 -858. doi: 10.3877/cma.j.issn.1674-0785.2024.09.009

综述

从PVAT 白色脂肪棕色化角度探讨中药在防治动脉粥样硬化中的应用
石佳娜1,2,(), 钱琳艳3,2, 姬凯悦1,2, 祁金文1,2, 胡情1,2, 孙佳斌1,2,4   
  1. 1.310014 杭州,浙江省人民医院(杭州医学院附属人民医院)药学部
    2.310014 杭州,杭州医学院
    3.310014 杭州,浙江省人民医院(杭州医学院附属人民医院)心血管内科
    4.313200 浙江湖州,德清县人民医院药学部
  • 收稿日期:2024-07-01 出版日期:2024-09-15
  • 通信作者: 石佳娜
  • 基金资助:
    浙江省基础公益研究项目(LGF22H280012)浙江省中医药科技计划项目(2022ZB037)浙江省中西医结合学会临床药学科研基金(2019LY017)浙江省药学会医院药学专项科研资助项目(2018ZYY11)

Discussion of application of traditional Chinese medicine in atherosclerosis from the perspective of browning of white adipose tissue

Jiana Shi1,2,(), Linyan Qian3,2, Kaiyue Ji1,2, Jinwen Qi1,2, Qing Hu1,2, Jiabin Sun1,2,4   

  1. 1.Department of Pharmacy, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou 310014, China
    2.Hangzhou Medical College,Hangzhou 310014, China
    3.Department of Cardiovascular Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou 310014, China
    4.Department of Pharmacy, Deqing People's Hospital, Huzhou 313200, China
  • Received:2024-07-01 Published:2024-09-15
  • Corresponding author: Jiana Shi
引用本文:

石佳娜, 钱琳艳, 姬凯悦, 祁金文, 胡情, 孙佳斌. 从PVAT 白色脂肪棕色化角度探讨中药在防治动脉粥样硬化中的应用[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 853-858.

Jiana Shi, Linyan Qian, Kaiyue Ji, Jinwen Qi, Qing Hu, Jiabin Sun. Discussion of application of traditional Chinese medicine in atherosclerosis from the perspective of browning of white adipose tissue[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2024, 18(09): 853-858.

动脉粥样硬化是一种慢性动脉炎症性疾病,其特征为脂质、炎症和内皮功能障碍的积累,是导致糖尿病、冠心病等代谢性疾病的主要病因之一。其发病机制复杂多变,迄今尚未阐明。研究发现在肥胖、炎症等病理状态下,血管周围脂肪组织会通过脂肪细胞表型转化进而释放脂肪因子及炎症因子并调节各类炎症细胞,“由外而内”调控动脉粥样硬化进程。研究发现中药可以通过调节血管周围脂肪结构比例与功能,具有防治动脉粥样硬化的作用。本文综述单味中药、中药单体及中药复方通过调控血管周围脂肪白色脂肪棕色化来防治动脉粥样硬化的作用机制,以期为临床治疗提供新方法新思路。

Atherosclerosis is a chronic inflammatory arterial disease characterized by the accumulation of lipids, inflammation, and endothelial dysfunction, and it is one of the main causes of metabolic diseases such as diabetes and coronary heart disease. Its pathogenesis is complex and variable,and has not yet been fully elucidated. Research has found that under pathological conditions such as obesity and inflammation, perivascular adipose tissue undergoes adipocyte phenotypic transformation, leading to the release of adipokines and inflammatory cytokines, and regulates various inflammatory cells, thereby regulating the progression of atherosclerosis "from outside to inside". Studies have found that traditional Chinese medicine can prevent and treat atherosclerosis by regulating the proportion and function of perivascular adipose tissue. This article reviews the mechanism of action of single Chinese herbs, single herb constituents, and Chinese herbal formulas in preventing and treating atherosclerosis by regulating the browning of perivascular adipose tissue, aiming to provide new methods and ideas for clinical treatment.

1
Lusis AJ. Atherosclerosis [J]. Nature, 2000, 407(6801): 233-241.
2
Huh JY, Park YJ, Ham M, et al. Crosstalk between adipocytes and immune cells in adipose tissue inflammation and metabolic dysregulation in obesity [J]. Mol Cells, 2014, 37(5): 365-371.
3
Qi XY, Qu SL, Xiong WH, et al. Perivascular adipose tissue (PVAT) in atherosclerosis: a double-edged sword [J]. Cardiovasc Diabetol, 2018,17(1):134.
4
Cai M, Zhao D, Han X, et al. The role of perivascular adipose tissuesecreted adipocytokines in cardiovascular disease [J]. Frontiers in immunology, 2023, 14: 1271051.
5
Trayhurn P, Wood IS. Adipokines: inflammation and the pleiotropic role of white adipose tissue [J]. Br J Nutr, 2004, 92(3):347-355.
6
DMarco L, Puchades MJ, Gorriz JL, et al. Epicardial adipose tissue,adiponectin and leptin: A potential source of cardiovascular risk in chronic kidney disease [J]. Int J Mol Sci, 2020, 21(3): 978-991.
7
刘慧, 白冰. 血管周围脂肪组织与心血管疾病的关系 [J]. 心血管病学进展, 2018, 39(04): 640-643.
8
Cedikova M, Kripnerová M, Dvorakova J, et al. Mitochondria in White, Brown, and Beige Adipocytes [J]. Stem Cells Int , 2016,2016:6067349.
9
Adamczak M, Wiecek A. The adipose tissue as an endocrine organ [J].Semin Nephrol, 2013, 33(1):2-13.
10
Cittadini A, Mantzoros CS, Hampton TG, et al. Cardiovascular abnormalities in transgenic mice with reduced brown fat: an animal model of human obesity [J]. Circulation, 1999, 100(21): 2177-2183.
11
Takx RA, Ishai A, Truong QA, et al. Supraclavicular brown adipose tissue 18F-FDG uptake and cardiovascular disease [J]. J Nucl Med,2016, 57(8): 1221-1225.
12
Odermatt TS, Dedual MA, Borsigova M, et al. Adipocyte-specific GP130 signalling mediates exercise-induced weight reduction [J]. Int J Obes( Lond), 2020, 44(3):707-714.
13
程龙, 朱耀萱, 周晶, 等. 冷暴露对高脂饮食小鼠脂肪棕色化的影响[J]. 中国药理学通报, 2019, 35(6):802-809.
14
Finlin BS, Memetimin H, Confides AL, et al. Human adipose beiging in response to cold and mirabegron [J]. JCI Insight, 2018,3(15):e121510.
15
Zhang Z, Cui Y, Su V, et al. A PPARγ/long noncoding RNA axis regulates adipose thermoneutral remodeling in mice [J]. J Clin Invest,2023,133(21):e170072.
16
Miranda CS, Silva-Veiga FM, Santana-Oliveira DA, et al. PPARα/γ synergism activates UCP1-dependent and -independent thermogenesis and improves mitochondrial dynamics in the beige adipocytes of highfat fed mice [J]. Nutrition, 2024, 117:112253.
17
Kraakman MJ, Liu Q, Postigo-Fernandez J, et al. PPARgamma deacetylation dissociates thiazolidinedione's metabolic benefits from its adverse effects [J]. J Clin Invest, 2018, 128(6): 2600-2612.
18
Wu D, Eeda V, Undi RB, et al. A novel peroxisome proliferatoractivated receptor gamma ligand improves insulin sensitivity and promotes browning of white adipose tissue in obese mice [J]. Mol Metab, 2021, 54: 101363.
19
Chen X, Yang L, Zhai SD. Risk of cardiovascular disease and allcause mortality among diabetic patients prescribed rosiglitazone or pioglitazone: a meta-analysis of retrospective cohort studies [J]. Chin Med J (Engl), 2012, 125(23): 4301-4306.
20
Juurlink DN, Gomes T, Lipscombe LL, et al. Adverse cardiovascular events during treatment with pioglitazone and rosiglitazone: population based cohort study [J]. BMJ, 2009, 339: b2942.
21
Tiraby C, Langin D. PGC-1alpha, a transcriptional coactivator involved in metabolism [J]. Med Sci (Paris), 2005, 21(1): 49-54.
22
Grzeszczuk M, Dziegiel P, Nowińska K. The role of FNDC5/Irisin in cardiovascular disease [J]. Cells, 2024, 13(3): 277.
23
聂永伟. 鸢尾素的定位机制及其功能研究 [D]. 呼和浩特: 内蒙古大学, 2016.
24
Seale P, Bjork B, Yang W, et al. PRDM16 controls a brown fat/skeletal muscle switch [J]. Nature, 2008, 454(7207): 961-967.
25
Cohen P, Levy JD, Zhang Y, et al. Ablation of PRDM16 and beige adipose causes metabolic dysfunction and a subcutaneous to visceral fat switch [J]. Cell, 2014, 156(1-2): 304-316.
26
Kajimura S, Seale P, Kubota K, et al. Initiation of myoblast to brown fat switch by a PRDM16 -C/EBP-beta transcriptional complex [J].Nature, 2009, 460(7259): 1154-1158.
27
Seale P, Kajimural S, Yang W, et al. Transcriptional control of brown fat determination by PRDM16 [J]. Cell Metab, 2007, 6(1): 38-54.
28
Guo B, Liu J, Wang B, et al. Withaferin A promotes white adipose browning and prevents obesity through sympathetic nerve-activated prdm16-FATP1 axis [J]. Diabetes, 2022, 71(2): 249-263.
29
Timmons JA, Wennmalm K, Larsson O, et al. Myogenic gene expression signature establishes that brown and white adipocytes originate from distinct cell lineages [J]. Proc Natl Acad Sci USA,2007, 104(11): 4401-4406.
30
郑晓彬, 艾鹤英, 袁淑华, 等. SIRT1 基因缺陷对肥胖小鼠棕色脂肪功能的影响 [J]. 中华医学杂志, 2016, 96 (23): 1859-1862.
31
陶璐, 初楠, 韩洁, 等. 血清PECAM-1、Sirt1 水平与2 型糖尿病患者颈动脉粥样硬化的关系 [J/OL]. 中华临床医师杂志(电子版),2023, 17(3): 291-296.
32
李博涵. 靶向脂肪组织AMPK 调控能量代谢与抗肥胖作用研究[D]. 北京: 中国科学院大学, 2020.
33
Mottillo EP, Desjardins EM, Crane JD, et al. Lack of adipocyte AMPK exacerbates insulin resistance and hepatic steatosis through brown and beige adipose tissue function [J]. Cell Metab, 2016, 24(1): 118-129.
34
Bondurant LD, Potthoff MJ. Fibroblast growth factor 21: a versatile regulator of metabolic homeostasis [J]. Annual Rev Nutrit, 2018, 38:173-196.
35
Zhang L, Cai X, Ma F, et al. Two-step regulation by matrix Gla protein in brown adipose cell differentiation [J]. Mol Metab, 2024, 80: 101870.
36
Mu WJ, Song YJ, Yang LJ, et al. Bone morphogenetic protein 4 in perivascular adipose tissue ameliorates hypertension through regulation of angiotensinogen [J]. Front Cardiovasc Med, 2022,9: 1038176.
37
李萍, 周颖, 栾剑威, 等. 基于“卫气理论”探讨膏脂与血管周围脂肪组织的相关性 [J]. 湖南中医药大学学报, 2022, 42(11): 1948-1952.
38
王雨涵, 刘福明. 基于"脉损"学说辨治早期动脉粥样硬化 [J]. 北京中医药大学学报, 2023, 46(2): 186-190.
39
伍迪. 二氢杨梅素促进WAT 棕色化抵抗高脂饮食诱导的肥胖 [D].湖南衡阳, 南华大学, 2018.
40
白继昌, 谈力欣, 刘赞朝, 等. 葛根素对3T3-L1 脂肪细胞胰岛素抵抗的影响及机制研究[J]. 广西医科大学学报, 2024, 41(1): 40-45.
41
吕香州, 魏铭宏, 吴思惠, 等. 葛根素对松辽黑猪前体脂肪细胞成脂分化的影响 [J]. 中国畜牧兽医, 2021, 48(12): 4422-4428.
42
Andradejm O, Barcala Jorge AS, Batista-Jorge GC, et al. Effect of resveratrol on expression of genes involved thermo-genesis in mice and humans [J]. Biomed Pharmacother, 2019(112): 108634.
43
Zhang Z, Zhang H, Li B, et al. Berberine activates thermogenesisin white and brown adipose tissue [J]. Nat Commun, 2014, (5): 5493.
44
Lee E, Jung DY, Kim JH, et al. Transient receptor potentialvanilloid type4 channel regulates diet-induced obesity, insulinresistance, and leptin resistance [J]. FASEB J, 2015, 29(8): 3182-3192.
45
Fan L, Xu H, Yang R, et al. Combination of capsaicin and capsi-ate induces browning in 3T3 -Ll white adipocytes via activationof the peroxisome proliferator -activated receptor y/β(3)-ad-renergic receptor signaling pathways [J]. Journal of agricultural andfood chemistry,2019, 67(22): 6232-6240.
46
乔羽, 张京春, 刘玥, 等. 人参-川芎有效成分通过PPARγ/PGC-1α/UCP1 通路调控白色脂肪棕色化的机制研究 [J]. 中草药, 2022,53, (2): 478-483.
47
Lee K, Seo YJ, Song JH, et al. Ginsenoside Rgi promotesbrowning by inducing UCP¹expression and mitochondrial activ-ity in 3T3-L1 and subcutaneous white adipocytes [J]. J Ginseng Res, 2019, 43(4):589-599.
48
Park SJ, Park M, Sharma A, et al. Black ginseng and ginse-noside Rb1 promote browning by inducing UCP¹expression in3T3-L1 and primary white adipocytes [J]. Nutrients, 2019, 11(11): 2747.
49
Ma L, Zhao Z, Guo X, et al. Tanshinone ⅡA and its deriva-tive activate thermogenesis in adipocytes and induce “beiging” of white adipose tissue [J]. Mol Cell Endocrinol, 2022, 544: 111557.
50
Wang YJ, Huang SL, Feng Y, et al. Emodin, an 11β-hydroxysteroid dehydrogenase type 1 inhibitor,regulatesadipocyte function in vitro and exerts anti-diabetic effect in ob/obmice [J]. Acta Pharmacol Sin,2012, 33(9): 1195-1203.
51
宋冰, 刘学政. 大黄素对KKAy 糖尿病小鼠脂肪组织PPAR-α 及PPAR-γ 表达影响的实验研究 [J]. 北京中医药大学学报, 2012,35(10): 692-695.
52
程龙, 董世芬, 袁悦莹, 等. 大黄素对ApoE 基因敲除小鼠脂肪棕色化的影响 [J]. 中国比较医学杂志, 2018, 28(11): 8-14.
53
张世和. 黄芪多糖对C3H10T 1/2 细胞棕色脂肪分化的影响 [D]. 晋中: 山西农业大学, 2021.
54
Chou YJ, Kan WC, Chang CM, et al. Renal protective effects of low molecular weight of inonotus obliquus polysaccharide (LIOP) on HFD/STZ-induced nephropathy in mice [J]. Int J Mol Sci, 2016, 17(9):1535.
55
吴洁. 桦树茸提取物改善小鼠肥胖的作用机制及抗糖尿病作用研究 [D]. 郑州: 郑州大学, 2020.
56
陈青扬, 黄惠勇, 刘卜菡. 加味生脉补心丹对防治2 型糖尿病大鼠心肌损害的影响 [J].湖南中医药大学学报, 2016, 36(3): 5-8.
57
鲁丽君. 生脉注射液治疗108 例糖尿病合并冠心病疗效观察 [J].中国药物与临床, 2010, l0(10):1157-1158.
58
叶佐武, 徐金波, 鲁春芳, 等. 生脉饮调控STZ 诱导糖尿病大鼠心肌脂质代谢作用机制研究 [J]. 浙江中西医结合杂志, 2018, 28(7):537-541.
59
Liu X, Wang S, Wu Z, et al. Deoxyschizandrin loadedliposomes on the suppression lipid accumulation in 3T3-L1 adipocytes [J]. Molecules,2018, 23(9): 2158.
60
Zhu PL, Pan SY, Zhou SF, et al. Effects of combineddietary supplementation with fenofibrate and Schisandrae Fructuspulp on lipid and glucose levels and liver function in normal and hypercholesterolemic mice [J]. Drug Des Dev Ther, 2015, 9: 923-935.
61
何慧玲, 董敏健, 康敏, 等. 党参中过氧白术内酯Ⅲ的提取分离及促进脂解的机制研究 [J]. 遵义医科大学学报, 2022, 45(5): 559-566.
62
Tian Y, Gong P, Wu Y, et al. Screening and identification of potential active components in Ophiopogonis Radix against atherosclerosis by biospecific cell extraction [J]. J Chromatogr B Analyt Technol Biomed Life Sci, 2019, 1133: 121817.
63
方佳. 基于代谢组学和肠道菌群分析探讨麦冬寡糖抗2 型糖尿病的作用机制 [D]. 广州: 广州中医药大学, 2021.
64
张小清, 许文华, 肖鑫, 等. 葛根芩连汤促进糖尿病大鼠棕色脂肪分化改善糖脂紊乱的分子机制 [J]. 中国中药杂志, 2021, 46(17):4462-4470.
65
张小清. 葛根芩连汤促进脂肪能量代谢改善糖脂紊乱的分子机制[D]. 南昌: 江西中医药大学, 2021.
66
王琳琳, 胡可佳. 葛根芩连汤对肥胖小鼠的脂质代谢的作用及其机制研究 [J]. 世界中西医结合杂, 2021, 16(7): 1231-1236.
67
吴云起, 唐汉庆, 吴翠松, 等. 脾阳虚证大鼠棕色脂肪组织和解偶联蛋白1 关联性的研究 [M]. 中国中医科学院中药研究所; 中国中西医结合学会中药专业委员会, 2011.
68
彭凯夫. 黄连温胆汤对2 型糖尿病小鼠白色脂肪棕色化以及脂肪中PI3K/ AKT 通路表达的影响 [D]. 成都: 成都体育学院, 2021.
69
任美玲. 温胆汤对肥胖痰湿证模型大鼠棕色脂肪脂质代谢相关基因UCP1 启动子甲基化及其表达的影响 [D]. 南昌: 江西中医药大学, 2023.
70
于澄元. 碧生源牌茯苓泽泻片减肥作用健脾利湿功效及其机制研究 [D]. 天津: 天津中医药大学, 2023.
71
丁婧, 赵洁, 王萌萌, 等. 基于GLP-1R/cAMP/PKA/CREB 的泽泻汤促进白色脂肪棕色化/激活棕色脂肪作用机制研究 [J]. 中国中药杂志, 2023, 48(21): 5851-5862.
72
Zhang X, Zhang QX, Wang X, et al. Dietary luteolin activates browning and thermogenesis in mice through an AMPK/PGCla pathway-mediated mechanism [J]. Int JObes (Lond), 2016, 40(12):1841-1849.
73
刘瑶瑶, 阎博华. 从白色脂肪棕色化及棕色脂肪活化角度探讨肥胖温阳中药的应用 [J]. 中华中医药杂志, 2022, 37(2): 947-950.
74
于澄元, 樊薛津, 庄朋伟, 等. 植物雌激素类中药诱导白色脂肪组织棕色化的研究进展[J]. 中南药学, 2023, 21(1): 161-168.
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