通讯作者: 伍建光, wjgnc@sina.com

DOI：10.12201/bmr.202501.00011

Research progress on the role of endoplasmic reticulum stress in atherosclerosis based on triple energizer theory

• 摘要：动脉粥样硬化（Atherosclerosis，AS）是心脑血管疾病的病理基础1，与其相关的疾病包括缺血性心脏病、外周动脉疾病等2。Chen3等人发现，与AS相关疾病的全球发病率呈总体上升趋势。AS的发生主要是由大动脉中的脂质积聚引起，逐渐形成斑块肿大、坏死核心形成和斑块钙化4。近年来，大量研究发现5，内质网应激（Endoplasmic Reticulum Stress，ERS）在动脉斑块易损性的进展和冠状AS急性并发症的发生中发挥作用。ERS在AS病变中长期激活细胞，可能导致促AS因子在晚期AS病变中的表达6，而通过调节ERS可以缓解AS病变和斑块脆弱性，是防治AS的关键靶点，也是目前的研究热点。中医认为AS属于“心悸”、“脉痹”等范畴，“三焦壅塞不通，痰瘀阻滞血脉”是其关键病机。三焦为水道，主通行元气、疏通水道，三焦壅塞不通，则水道升降失司，运行不畅，阴邪积聚，易化生痰湿瘀浊等邪，进而阻滞气机，久之阻滞血脉，最终导致AS的发生。结合中医理论与近年来的现代细胞生物学和分子生物学，三焦与内质网（Endoplasmic Reticulum，ER）在结构和生理功能上存在高度相关性。故本文基于“三焦”理论和 ERS，从中西医角度论述 AS病理机制，以期为防治AS提供新视角。

  关键词： 动脉粥样硬化；三焦理论；内质网应激；中医药；研究进展; ; ; ; ; 

   

  Abstract: Atherosclerosis (AS) is the pathological basis of cardiovascular and cerebrovascular diseases 1, and its related diseases include ischemic heart disease, peripheral artery disease, etc. 2. Chen 3 and others found that the global incidence rate of AS related diseases showed an overall upward trend. The occurrence of atherosclerosis is mainly caused by the accumulation of lipids in large arteries, gradually leading to plaque enlargement, necrotic core formation, and plaque calcification 4. In recent years, a large number of studies have found 5 that endoplasmic reticulum stress (ERS) plays a role in the progression of arterial plaque vulnerability and the occurrence of acute complications of coronary atherosclerosis. Long term activation of cells by ERS in AS lesions may lead to the expression of pro AS factors in advanced AS lesions 6. Regulating ERS can alleviate AS lesions and plaque vulnerability, which is a key target for the prevention and treatment of AS and a current research hotspot. Traditional Chinese Medicine believes that AS belongs to the categories of palpitations and pulse obstruction, and the key pathogenesis is obstruction of the three burners and blockage of the blood vessels by phlegm and blood stasis. Sanjiao is a waterway that mainly flows vital energy and unclogs the waterway. If Sanjiao is blocked, the waterway will lose its flow and operation, leading to the accumulation of yin and pathogenic factors such as phlegm, dampness, blood stasis, etc., which can block the qi flow and blood vessels for a long time, ultimately leading to the occurrence of atherosclerosis. Combining traditional Chinese medicine theory with modern cell biology and molecular biology in recent years, there is a high correlation between the structure and physiological function of the triple junction and endoplasmic reticulum (ER). Therefore, based on the Three Jiao theory and ERS, this article discusses the pathological mechanism of AS from the perspective of traditional Chinese and Western medicine, in order to provide a new perspective for the prevention and treatment of AS.

  Key words: Atherosclerosis; Three Jiao theory; Endoplasmic reticulum stress; Traditional Chinese Medicine; Pathogenesis; Treat

  提交时间：2025-01-04

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