Role of Endoplasmic Reticulum Stress in Atherosclerosis and Its Regulation by Traditional Chinese Medicine: A Review / 中国实验方剂学杂志
Chinese Journal of Experimental Traditional Medical Formulae
; (24): 226-235, 2024.
Article
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| ID: wpr-1006288
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ABSTRACT
Atherosclerosis (AS) is a chronic inflammatory pathological process in which lipid and/or fibrous substances are deposited in the intima of arteries, and it is one of the pathological bases of many cardiovascular and cerebrovascular diseases. Endoplasmic reticulum stress (ERS) is a protective mechanism of cell adaptation. Moderate ERS can reduce abnormal protein aggregation and increase the degradation of misfolded proteins to repair and stabilize the internal environment, while excessive ERS can cause unfolded protein reaction, activate inflammation, oxidative stress, apoptosis, autophagy, and other downstream pathways, and lead to cell damage, or even apoptosis. A large number of studies have shown that ERS mediates a variety of pathological processes related to AS, affects endothelial cells, smooth muscle cells, macrophages, endothelial progenitor cells, and other cell components closely related to its occurrence and development, influences the progress of AS by regulating cell function, and promotes the formation of AS plaque, the transformation of stable plaque to unstable plaque, and the rupture of unstable plaque. Regulation of ERS may be a key target for the prevention and treatment of AS, and it is a research hotspot at present. Traditional Chinese medicine (TCM) believes that the origin of AS is the imbalance of Yin and Yang, the disharmony of Zangfu organs, and the abnormal operation of Qi, blood, and body fluid, which leads to the accumulation of phlegm, blood stasis, and other pathological products in the pulse channels, making the blood flow blocked or misfunction and causing the disease, which belongs to the syndrome of deficiency in origin and excess in superficiality. As the pathogenesis of AS is complex, and the symptoms are diverse, TCM has significant advantages in treating AS because of its multiple targets, multiple pathways, stable efficacy, strong individualization, and high safety. This paper systematically elaborated on the role of ERS in the occurrence and development of AS and summarized the mechanism research on the regulation and control of ERS by Chinese herbal monomer, Chinese herbal extract, Chinese herbal compound, and proprietary medicine, so as to provide a theoretical basis for clinical research and drug development in the prevention and treatment of AS.