摘要
慢性荨麻疹(CU)作为全球范围内常见皮肤疾病,各地区发病率逐年攀升,伴发严重瘙痒等临床表现,可影响正常工作、睡眠及日常生活,增加压力、焦虑、抑郁等负性心理负担;免疫球蛋白(Ig)E超敏反应诱发肥大细胞活化和脱颗粒进程异常激活是CU核心发病机制之一,目前尚无治愈手段。临床治疗CU首选西替利嗪、氯雷他定等抗组胺药物,可以有效改善风团瘙痒等临床表现,然而长期应用可增加不良反应风险并产生耐药。磷脂酰肌醇3-激酶/蛋白激酶B(PI3K/Akt)信号通路作为与磷脂酰肌醇、酪氨酸激酶受体(RTK)调节的经典信号通路之一,是调控巨噬细胞细胞因子产生和释放、影响白细胞迁移、进而影响肥大细胞活化及炎症反应的关键靶点,可参与IgE超敏反应诱发肥大细胞活化和脱颗粒进程及补体系统异常激活等多种代谢进程,因此,PI3K/Akt分子通路可能是未来根治慢性荨麻疹的重要靶点。目前国内关于PI3K/Akt信号通路在慢性荨麻疹治疗中的机制及潜在作用报道较少,现就PI3K/Akt信号通路调节在慢性荨麻疹治疗中的分子机制进行综述,从分子调控、网络药理学分析的视角为中医药治疗慢性荨麻疹提供佐证及治疗策略选择。
Chronic urticaria(CU)is a common skin disease worldwide,and its incidence is increasing year by year in various regions.Clinical manifestations such as severe itching can affect normal work,sleep,and daily life and increase the negative psychological burden caused by stress,anxiety,and depression.Mast cell activation and degranulation induced by immunoglobulin(Ig)E hypersensitivity is one of the core pathogenic mechanisms of CU,and there is no cure.Antihistamines such as cetirizine and loratadine are preferred for the clinical treatment of CU.Although they can effectively improve clinical manifestations such as itchiness,longterm application can increase the risk of adverse reactions and drug resistance.The phosphatidylinositol kinase/serine-threonine protein kinase B(PI3K/Akt)signaling pathway,as a classical signaling pathway regulated by phosphatidylinositol and tyrosine kinase receptor(RTK),is a key target regulating the production and release of cytokines in macrophages and affecting the migration of leukocytes and the activation of mast cells and inflammation,and it can be involved in a variety of metabolic processes,such as mast cell activation and degranulation induced by IgE hypersensitivity and abnormal activation of the complement system so that the PI3K/Akt molecular pathway could be an important target for the future eradication of CU.However,the mechanism and potential role of the PI3K/Akt signaling pathway in the treatment of CU are less reported in China.Now,this paper reviewed the molecular mechanism of PI3K/Akt signaling pathway regulation in the treatment of CU and provided corroborative evidence and therapeutic strategy choices for the treatment of CU with traditional Chinese medicine(TCM)from the perspectives of molecular regulation and network pharmacology analysis.
作者
吉凯峰
蔡海斌
伍洲炜
郑玉婷
徐晓倩
宋瑜
JI Kaifeng;CAI Haibin;WU Zhouwei;ZHENG Yuting;XU Xiaoqian;SONG Yu(Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2024年第17期292-298,共7页
Chinese Journal of Experimental Traditional Medical Formulae
基金
上海申康医院发展中心“促进市级医院临床技能与临床创新能力三年行动计划项目”(SHDC2020CR3092B)
上海市科学技术委员会“科技创新行动计划”医学创新研究专项(20Y21901500)
上海中医药大学附属龙华医院科技创新项目(KY1793)
龙华医院科研项目(KY1923)。
关键词
慢性荨麻疹
中医药
磷脂酰肌醇3-激酶/蛋白激酶B信号通路
网络药理学
综述
chronic urticaria
traditional Chinese medicine
phosphatidylinositol kinase/serine-threonine protein kinase B signaling pathway
network pharmacology
review
