中药调控芳香烃受体治疗溃疡性结肠炎的研究进展

Research Progress on the Regulation of Aryl Hydrocarbon Receptor by Chinese Medicine in the Treatment of Ulcerative Colitis

关键词:  溃疡性结肠炎(UC)  芳香烃受体(AHR)  中医药  作用机制  研究进展

Key words:  Ulcerative colitis (UC)  Aryl hydrocarbon receptor (AHR)  Traditional Chinese Medicine  Mechanism of action  Research progress

摘要:

溃疡性结肠炎(Ulcerative Colitis, UC)是一种慢性、复发性的肠道黏膜炎症疾病,其发病机制复杂,与炎症、免疫失衡、肠道屏障损伤、肠道菌群紊乱密切相关。现有以抗炎为主的治疗疗效不佳且可引起多种不良反应,长期使用亦会产生耐药性。研究表明,上调或激活芳香烃受体(Aryl Hydrocarbon Receptor, AHR)可抑制炎症反应、调控免疫稳态、修复肠道屏障从而缓解UC,且UC患者AHR表达异常,因此AHR被认为是UC治疗的有效靶点。中医药具有多成分、多靶点、多途径的特点,可有效改善UC患者症状,防止复发,提升患者生活质量。研究发现,中药多糖类、皂苷类、黄酮类等成分及复方黄芩汤、白头翁汤、葛根芩连汤等可直接或调控肠道菌群间接上调或激活AHR,从而通过抑制炎症、平衡免疫、修复肠道屏障来缓解UC,且多种作用机制可相互协同。通过系统总结UC异常的病理机制及AHR调控机制,据此探讨中药及复方调控AHR治疗UC的具体作用机制,以期推动中医药治疗UC的深入研究及在临床中的精准运用,为UC治疗提供新的思路与方法。

Abstract:

Ulcerative colitis (UC) is a chronic and relapsing inflammatory disease of the intestinal mucosa, characterized by a complex pathogenesis involving inflammation, immune imbalance, intestinal barrier damage, and gut microbiota dysbiosis. Current anti-inflammatory therapies exhibit suboptimal efficacy, cause multiple adverse effects, and may lead to drug resistance with long-term use. Studies indicate that upregulating or activating the Aryl Hydrocarbon Receptor (AHR) can alleviate UC by suppressing inflammation, regulating immune homeostasis, and repairing the intestinal barrier. Given the aberrant AHR expression in UC patients, AHR is recognized as a promising therapeutic target. Traditional Chinese Medicine (TCM), with its characteristics ofmultiple components, multiple targets, and multiple pathways, effectively improves symptoms, prevents recurrence, and enhances the quality of life in UC patients. Research reveals that TCM components—such as polysaccharides, saponins, and flavonoids—and compound formulas (e.g.,Huangqin Tang,Baitouweng Tang, andGegen Qinlian Tang) candirectly or indirectly upregulate/activate AHRby modulating gut microbiota, thereby ameliorating UC throughanti-inflammatory effects, immune balance restoration, and barrier repair, with synergistic interactions among these mechanisms. This review systematically summarizes the pathological mechanisms of UC and the regulatory mechanisms of AHR, explores the specific mechanisms of TCM interventions targeting AHR for UC treatment, and aims topromote in-depth research and advance precision clinical applicationsof TCM, offering novel strategies for UC management.