糖尿病作为临床上常见的慢性代谢性疾病,与其联系紧密的糖尿病肾病、糖尿病视网膜病变、糖尿病周围神经病变、糖尿病心肌病、糖尿病足等都属于糖尿病并发症.以往研究发现,中药单体及复方的活性成分可调节磷脂酰肌醇3-激酶(PI3K)/蛋白激酶B(Akt)/哺乳动物雷帕霉素靶蛋白(mTOR)、腺苷酸活化蛋白激酶(AMPK)、丝裂原活化蛋白激酶(MAPK)、PTEN诱导假定激酶/帕金森病蛋白(PINK1/Parkin)、沉默信息调节因子1(SIRT1)等信号通路,通过上调自噬相关蛋白水平表达,调节异常葡萄糖代谢,改善微循环,抑制炎症及氧化应激反应,促进自噬,以治疗相关疾病.本文通过系统梳理多种自噬相关信号通路,总结中药干预自噬相关通路治疗糖尿病并发症的研究成果,以期为研究自噬在糖尿病并发症中的作用机制提供新的思路.
As a common chronic metabolic disease in clinical practice,diabetes mellitus is closely associated with nephropathy,retinopathy,peripheral neuropathy,cardiomyopathy,and diabetic foot,which are all diabetic complications.Studies have shown that the active ingredients of Chinese herbal medicines and the Chinese medicinal prescriptions can modulate the phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt)/mammalian target of rapamycin(mTOR),AMP-activated protein kinase(AMPK),mitogen-activated protein kinase(MAPK),PTEN-induced putative kinase 1/Parkinson's disease-associated protein Parkin(PINK1/Parkin),silent information regulator 1(SIRT1)and other signaling pathways to up-regulate the expression levels of autophagy-related proteins,regulate abnormal glucose metabolism,improve microcirculation,inhibit inflammation and oxidative stress,and promote autophagy,thus treating these complications.We summarized the autophagy-related signaling pathways and reviewed the research results of Chinese medicine interfering in autophagy-related pathways in the treatment of diabetic complications,aiming to provide new ideas for deciphering the role of autophagy in diabetic complications.