RESUMEN
Ulcerative colitis (UC), a disease that affects the colon or rectum, is characterized by long-term recurrent inflammation and eventually leads to ulcers in the inner wall of the intestine. The disease has a high incidence and is difficult to be cured, which causes severe physical and mental discomfort and economic burden to the patients. Therefore, it is urgent to develop new therapies with high cure rate and low side effect. The pathological mechanism of UC is complex and involves multiple factors. The intestinal mucosal barrier damage is the main pathological basis of UC, which is a hot topic and a new research direction. Intestinal tight junction (TJ), as the structural basis of the intestinal mucosal mechanical barrier, can actively regulate mucosal function and play a key role in the pathogenesis of UC. Traditional Chinese medicine (TCM) can regulate TJ protein via multiple pathways and multiple targets, repair the intestinal mucosal barrier, and thus block the progression of UC. Studies have demonstrated that Chinese herbal medicines and their components, Chinese medicine compound prescriptions, and Chinese medicine preparations can treat UC by regulating TJ protein to maintain the function and reduce the permeability of intestinal epithelium, providing a new therapeutic strategy for UC. Although TCM has unique advantages that western medicine cannot replace by mediating TJ protein expression in UC, a comprehensive review of this field remains to be carried out. Focusing on the status of UC and TCM syndrome differentiation and treatment, we retrieved relevant articles with ''ulcerative colitis'', ''tight junction'', and ''Chinese medicine'' as the keywords, and summarized the relationship of TJ and its key target proteins with UC to clarify the critical role of TJ in UC pathophysiology. Furthermore, we summarized the Chinese medicines regulating TJ in the treatment of UC in recent years, aiming to provide a theoretical basis for the development of drugs for this disease.
RESUMEN
Ulcerative colitis (UC) mainly occurs in the colon and rectum, with complex pathological mechanism. The occurrence of ulcerative colitis is associated with the uncontrollable inflammatory response of the intestine. The Western medicine therapy of UC mainly uses glucocorticoids and immunosuppressants to reduce intestinal inflammation. While blocking the progress of UC to a certain extent, it causes severe adverse reactions. More and more studies have confirmed that traditional Chinese medicine (TCM) has obvious advantages in the prevention and treatment of UC and can significantly reduce the recurrence of the disease. Pyroptosis, a novel form of cell death, can destroy cell structure, release intracellular pro-inflammatory substances, and mediate intestinal immune response in UC. TCM can promote pyroptosis (removing excess) or inhibit pyroptosis (replenishing deficiency), which is consistent with the regulation of Yin and Yang. TCM plays a role in the treatment of UC mainly by inhibiting pyroptosis (replenishing deficiency) and reducing intestinal immune response. In recent years, a large number of studies have been carried out to decipher the mechanism of TCM in the treatment of UC via NOD-like receptor protein domain 3 (NLRP3)-mediated pyroptosis pathway. The results have demonstrated that NLRP3 pathway is the key target of TCM in the treatment of UC. However, a comprehensive summary remains to be carried out on the inhibition of NLRP3-mediated pyroptosis pathway by TCM in the treatment of UC. Therefore, we retrieved the articles in this field in recent years with the keywords "pyroptosis", "NLRP3", "ulcerative colitis", and "Chinese medicine". The Chinese medicines regulating NLRP3 pathway mainly have the functions of clearing heat and drying dampness, harmonizing Qi and blood, moving Qi and dredging fu-organs, and invigorating spleen and removing dampness. The findings can help researchers to fully understand the mechanism of TCM in the treatment of UC via the NLRP3 pathway and provide a theoretical basis for the treatment of UC and further drug development.
RESUMEN
Ulcerative colitis (UC) is a clinical chronic intestinal disease, and the damage of the intestinal epithelial mucus barrier is an important pathological mechanism of UC. Mucin 2 (MUC2) is a major component of the intestinal mucus barrier, and goblet cells are the “main force” of MUC2 secretion, maintaining and renewing the intestinal mucus layer to ensure its integrity. Therefore, repairing the intestinal mucus barrier by promoting the synthesis of MUC2 by goblet cells is an important strategy for the treatment of UC. Traditional Chinese medicine scholars believe that there is an inherent layer of “lipid membrane” or “fat paste” in the intestine, and pathological factors such as moisture and heat lead to the thinning of this structure, which is the fundamental pathogenesis of “diarrhea” and “intestinal dysentery”. It coincides with the damage of intestinal mucus barrier leading to UC in modern medicine. Based on this, this paper summarized the mechanism of Chinese herbal compounds or Chinese herbal active components in regulating intestinal mucus barrier to interfere with UC. It was found that Chinese herbal compounds such as Huanglian jiedu decoction, Shaoyao decoction and Compound Kusen decoction, as well as Chinese herbal active ingredients such as volatile oil of Atractylodes lancea, paeoniflorin and papaya triterpenes could promote the synthesis and secretion function of goblet cells, and achieve the purpose of “thickening intestine”, thus relieving UC symptoms.