细胞外囊泡在中药干预缺血性心脑血管疾病血栓炎症中的研究进展

doi:10.19803/j.1672-8629.20250695

摘要/Abstract

摘要： 目的探讨细胞外囊泡（EVs）在中药治疗缺血性心脑血管疾病核心病理“血栓炎症”中的作用机制,分析中药重塑EVs通信网络的策略与临床转化面临的挑战。方法系统梳理中药调控EVs的文献,重点归纳其影响EVs生物发生及递送的“源头治理”与“精准装载”策略,剖析体内代谢复杂性与EVs异质性对临床疗效评价的约束。结果中药主要通过两大策略重塑血栓炎症微环境。①“源头治理”,即通过改善母细胞线粒体代谢,提升保护性EVs质量并遏制促栓性EVs生成,诠释“益气”维持微循环稳态的生物学内涵;②“精准装载”,即物理性阻断致病miRNA向EVs装载,切断炎症向凝血系统的级联传递,体现“化瘀”对信号通路的精准解耦。然而,体内代谢“黑箱”与血液EVs的高背景噪音仍是临床转化的主要技术壁垒。结论 EVs是中药干预血栓炎症的关键通讯介质。中药不仅能优化内源性EVs的抗栓抗炎活性,还可利用工程化EVs实现跨屏障精准递送。建议基于单颗粒分析的特异性EVs评价标准,推动中医药研究向精准的“细胞通讯重塑”跨越。

关键词: 中药, 细胞外囊泡, 缺血性心脑血管疾病, 血栓炎症, 机制, 临床转化

Abstract: Objective To investigate the mechanisms of extracellular vesicles (EVs) in Traditional Chinese Medicine (TCM) against “thromboinflammation” in ischemic cardio-cerebrovascular diseases, analyze the way TCM reshapes EV communication networks, and challenges to clinical translation. Methods Literature regarding TCM regulation of EVs was reviewed to summarize strategies for “addressing the root cause of problems” and “precision loading” that affected the biogenesis and delivery of EVs. Constraints imposed by in vivo metabolic complexity and EV heterogeneity on evaluation of clinical efficacy were analyzed. Results TCM remodeled the thromboinflammatory microenvironment primarily through two strategies: ① “addressing the root cause of problems”, which could help improve mitochondrial metabolism in parent cells to enhance protective EVs and curb pro-thrombotic EV generation while interpreting the biological basis of “Qi-boosting” (Yiqi), and ② “precision loading”, which meant physically blocking pathogenic miRNAs from loading into EVs, severing the inflammation-coagulation cascade and embodying “blood-activating” (Huoxue) signal decoupling. However, the “black box” of in vivo metabolism and high background noise of blood EVs remained technical barriers to translation. Conclusion EVs are crucial mediators for TCM interventions in thromboinflammation. TCM can not only optimize endogenous EV activity, but also use engineered EVs for precise delivery. It is recommended that evaluation standards be established for specific EVs based on single-particle analysis so as to promote the transition of TCM research toward precise “cell communication remodeling”.

Key words: Traditional Chinese Medicine, Extracellular Vesicles, Ischemic Cardio-Cerebrovascular Diseases, Thromboinflammation, Mechanism, Clinical Translation

中图分类号:

R972
R256

白雪, 李雪丽. 细胞外囊泡在中药干预缺血性心脑血管疾病血栓炎症中的研究进展[J]. 中国药物警戒, 2026, 23(6): 607-612.

BAI Xue, LI Xueli. Research Progress in Roles of Extracellular Vesicles in Thromboinflammation in Ischemic Cardio-Cerebrovascular Diseases Treated with Traditional Chinese Medicine[J]. Chinese Journal of Pharmacovigilance, 2026, 23(6): 607-612.

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https://zgywjj.magtechjournal.com/CN/Y2026/V23/I6/607

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