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Zbrani epidemiološki in klinični dokazi kažejo, da je vnetje pomemben kritični dejavnik za številne človeške bolezni. Tako lahko zaviranje kroničnega vnetja pomaga pri odlaganju, preventivi in nadzoru nad številnimi kroničnimi boleznimi, vključno s cerebrovaskularnimi, kardiovaskularnimi, sklepnimi, kožnimi, pljučnimi, krvnimi, limfatičnimi, jetrnimi, pankreatičnimi in črevesnimi boleznimi. Številni naravni proizvodi tradicionalne kitajske medicine (TKM) so pokazali, da varno zavirajo poti, ki vodijo do vnetja, in nadzirajo bolezni, ki so povezane z vnetji.
TKM zelišča kot obetavna protivnetna sredstva
TKM se je razvila v preteklih 5000 letih z namenom preprečitve in obvladovanja človeških bolezni. Klinična prepoznava in diagnoza bolezni v TKM večinoma temeljita na teoriji jina in janga ter petih elementov (Lu et al., 2009). Tradicionalno sta pri zdravljenju dve najobičajnejši metodi apliciranja zelišč, in sicer zeliščni poparek (močan čaj, ki se mora namakati eno uro ali več) in formiranje tablet, kjer je vezivo med. Moderna zeliščna zdravila, ki so bila razvita kot nadomestek za standardne pripravke TKM, se nahajajo v dveh oblikah, in sicer kot praški (ali granule) in mazila (Wang et al., 2009). Učinki zelišč, rabljenih v TKM, in njihovih aktivnih komponent so bili demonstrirani na številnih živalih in modelih celičnih kultur, in sicer pri inhibiranju vnetnega odziva številnih organov, vključno s pljuči, požiralnikom, velikimi možgani, črevesjem, kožo, prostato, mlečnimi žlezami, jetri in trebušno slinavko (Pan et al., 2011; Ichikawa et al., 2003; Yarosh et al., 2006).
Močni dokazi sugerirajo, da kronično vnetje spodbuja razvoj številnih bolezni, kot so Alzheimerjeva bolezen, ateroskleroza, artritis, astma, sladkorna bolezen in vnetne črevesne bolezni. Preučevana kitajska zelišča so večinoma qi dodatki (補氣 bǔ qì), odstranjevalci vročine (清熱 qīng rè) zelišča, ki razrešujejo toksine (解毒 jiě dú), kot je opisano v teoriji TKM (Xie and Du, 2011). TKM ima dolgo zgodovino uporabe in glavne aktivne učinkovine (ki so identificirane in zabeležene) kitajskih zeliščih za odstranjevanje vročine in razstrupljanje imajo običajno širok spekter farmakoloških učinkov, vključno s protivnetnim delovanjem (Ren et al., 1994). Klinični poskusi so prav tako pokazali učinkovitost TKM pri preventivi in kot obliki terapije za številne kronične vnetne bolezni; prav tako so bili identificirani tudi s tem povezani mehanizmi.
Jasno je, da naravne bioaktivne učinkovine v zeliščih, ki so rabljena v TKM, lahko vplivajo na številne celične poti za signaliziranje in imajo znotraj celice precej tarčnih mest. Ti mehanizmi vključujejo:
a) modulacijo poti vnetne signalne transdukcije, ki so povezane z NF-κB, AP-1, PI3K/Akt, MAPKs, STATs, and TLRs,
b) induciranje antioksidativnih encimov, kot so SOD, glutation peroksidaza (GPx) in glutation reduktaza (GRx),
c) zmanjšanje proizvajanja vnetnih molekul, vključno z COX-2, NO in PGE2
d) ublažitev delovanja in aktivacije vnetnih celic,
e) sprememba regulacije celičnih funkcij in
f) sprememba ravnovesja med celično-derivatiziranimi Th1 in Th2
Poleg njihovega vpliva na reguliranje znotrajceličnih poti signaliziranja lahko aktivne komponente zelišč TKM prav tako inhibirajo izražanje dejavnikov rasti (VEGF, FGF-2 and TGF-β1) in MMPs, ki so pomembni kofaktorji za angiogenezo, celjenje ran in obnavljanje tkiv.
Te informacije doprinesejo k celotni zbirki dokazov, ki kažejo, da imajo proizvodi TKM zaradi svoje varnosti in protivnetne učinkovitosti lahko potencialno vlogo pri preventivi in zdravljenju kroničnih vnetnih bolezni. Poleg tega so potrebne nadaljnje obširnejše raziskave glede vpliva aktivnih zeliščnih izdelkov na patološke, imunološke, biokemične in molekularni biologiji sorodne vidike na bolezenske procese, kar lahko na koncu vodi do izboljšanih formulacij kemopreventive.
prevod: Tanja Topić
vir fotografij: internet
Anti-inflammatory activity of traditional Chinese medicinal herbs
Accumulating epidemiological and clinical evidence shows that inflammation is an important risk factor for various human diseases. Thus, suppressing chronic inflammation has the potential to delay, prevent, and control various chronic diseases, including cerebrovascular, cardiovascular, joint, skin, pulmonary, blood, lymph, liver, pancreatic, and intestinal diseases. Various natural products from traditional Chinese medicine (TCM) have been shown to safely suppress proinflammatory pathways and control inflammation-associated disease.
TCM herbs as promising anti-inflammatory agents
TCM has evolved over the past 5,000 years to prevent and manage human disease. The clinical recognition and diagnosis of disease in TCM are mainly based on the yin-yang and five elements theories (Lu et al., 2009). Traditionally, the two most common methods of applying herb treatments are to make a decoction (a strong tea that must be simmered for an hour or more) and to make large pills containing honey as a binding agent. However, modern herbs, developed to replace the standard Chinese preparations, come in two popular forms, namely, extract powders (or granules) and smooth (Wang et al., 2009). Herbs used in TCM and their active components have been demonstrated in many animal or cell culture models to inhibit inflammatory responses in different organs including the lung, esophagus, cerebrum, colon, skin, prostate, mammary glands, liver and pancreas (Pan et al., 2011; Ichikawa et al., 2003; Yarosh et al., 2006).
Strong direct evidence suggests that chronic inflammation promotes development of numerous human diseases such as Alzheimer's, atherosclerosis, arthritis, asthma, diabetes and IBD. The Chinese herbs investigated are mostly qi supplementation (補氣 bǔ qì), heat-clearing (清熱 qīng rè) and toxin-resolving (解毒 jiě dú) drugs, as described previously in the theory of TCM (Xie and Du, 2011). TCM has a long history of human use, and the main active components recorded and identified, in heat-clearing and detoxifying Chinese herbs usually have widespread pharmacological effects including anti-inflammatory actions (Ren et al., 1994). Clinical trials have also demonstrated the effectiveness of TCM for the prevention and therapy of many chronic inflammatory diseases, and the related mechanisms have also been identified.
It is clear that natural bioactive compounds from herbs used in TCM can interfere with multiple cell signaling pathways and have multiple targets within the cells.
These mechanisms include:
(a) modulation of inflammatory signal transduction pathways linked to NF-κB, AP-1, PI3K/Akt, MAPKs, STATs, and TLRs,
(b) induction of antioxidant enzymes such as SOD, glutathione peroxidase (GPx) and glutathione reductase (GRx),
(c) reduction of inflammatory molecule production including iNOS, COX-2, NO and PGE2
(d) diminished recruitment and activation of inflammatory cells,
(e) altered regulation of cellular functions and
(f) changes in the balance of Th1 and Th2 cell-derived cytokines
Besides their influence on the regulation of intracellular signaling pathways, the active components from TCM may also inhibit expression of growth factors (VEGF, FGF-2 and TGF-β1) and MMPs, which are important cofactors for angiogenesis, wound repair and tissue regeneration.
This information adds to the body of evidence indicating that the products of TCM, because of their safety and anti-inflammatory efficacy, may have a potential role in the prevention and treatment of chronic inflammatory disease. Furthermore, extensive research is needed concerning the influence of active herbal products on the pathological, immunological, biochemical and molecular biology-related aspects of disease processes, which may ultimately lead to enhanced formulations for chemoprevention.
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