中药调控核转录因子 κB 信号通路减轻皮瓣缺血再灌注损伤.

BACKGROUND: In recent years, it has been found that nuclear factor-κB signaling pathway aggravates ischemia-reperfusion injury of skin flaps by regulating downstream cytokines, and traditional Chinese medicine can inhibit the activation of nuclear factor-κB, thereby reducing ischemia-reperfusion injury of skin flaps. OBJECTIVE: To review the research progress in the regulation of nuclear factor-κB signaling pathway by Chinese medicine, its active ingredients and Chinese medicine compound against skin flap ischemia-reperfusion injury. METHODS: The first author searched for the relevant literatures published in CNKI and PubMed databases from January 2012 to October 2022 using the keywords of “Traditional Chinese Medicine (TCM), NF-κB, Skin flaps, vascular endothelial cell (VEC)” in Chinese and English, respectively. After screening, 45 articles were finally summarized for review. RESULTS AND CONCLUSION: Activated nuclear factor-κB signaling pathway can promote the release of inflammatory factors and adhesion molecules in tissue cells to anti-fibrinolytic and coagulant substances through the transcription of a variety of cytokines, and aggravate the inflammatory cascade reaction between ischemia-reperfusion-damaged flap tissue and vascular endothelial cells, leukocyte adhesion and microthrombus formation, leading to flap necrosis. Traditional Chinese medicine, its compounds and effective components (flavonoids, terpenoids, saponins, phenols, etc.) inhibit the activation of nuclear factor-κB signaling pathway, alleviate the inflammatory cascade reaction between the ischemia-reperfusion-damaged flap and vascular endothelial cells, leukocyte adhesion and thrombosis, and thereby inhibit ischemia-reperfusion injury of skin flaps. Research on the mechanism of nuclear factor-κB signaling pathway regulated by traditional Chinese medicine against ischemia-reperfusion injury of skin flaps provides a new idea for the drug research and development of skin flap ischemiareperfusion injury, and provides reference and theoretical basis for the clinical prevention and treatment of skin flap ischemia-reperfusion injury by traditional Chinese medicine and the acceleration of skin flap healing. [ABSTRACT FROM AUTHOR]