细胞自噬在针刺治疗多囊卵巢综合征胰岛素抵抗的作用研究进展
|
摘要
多囊卵巢综合征(PCOS)是一种妇产科临床常见的女性生殖内分泌紊乱性疾病,发病过程中常合并胰岛素抵抗(IR),对育龄期女性的身心健康产生恶劣影响。其发病机制复杂,迄今仍未被现代医学探明。中医认为,痰湿是PCOS的重要病机,针刺化痰治疗PCOS和IR均有疗效。细胞自噬参与PCOS发病全过程,mTOR通路是自噬的重要通路,针刺可通过mTOR通路调节自噬水平。本研究探讨细胞自噬在针刺治疗多囊卵巢综合征胰岛素抵抗中的作用机制,为临床研究PCOS提供新思路。
Objective: Polycystic ovary syndrome( PCOS) is one of the most common endocrine and metabolic disorder in gynecological department,and it is often associated with insulin resistance( IR) in the pathogenetic process,which has influenced the physical and mental health of the female of child-bearing period. The complexity of its pathogenesis has not yet been proved by modern medicine. TCM supposes that phlegm-dampness is substantial pathogenesis of PCOS,acupuncture has effectiveness for expectorant to treat PCOS and IR. Autophagy is involved in the pathogenesis of PCOS,mTOR pathway is the key pathway of autophagy,and acupuncture can regulate the autophagy through mTOR pathway. Therefore,this study investigated the effect of autophagy during acupuncture treating PCOS-IR,thus to provide new idea for clinical study of PCOS.
Objective: Polycystic ovary syndrome( PCOS) is one of the most common endocrine and metabolic disorder in gynecological department,and it is often associated with insulin resistance( IR) in the pathogenetic process,which has influenced the physical and mental health of the female of child-bearing period. The complexity of its pathogenesis has not yet been proved by modern medicine. TCM supposes that phlegm-dampness is substantial pathogenesis of PCOS,acupuncture has effectiveness for expectorant to treat PCOS and IR. Autophagy is involved in the pathogenesis of PCOS,mTOR pathway is the key pathway of autophagy,and acupuncture can regulate the autophagy through mTOR pathway. Therefore,this study investigated the effect of autophagy during acupuncture treating PCOS-IR,thus to provide new idea for clinical study of PCOS.
引文
[1]Li R,Zhang QF,Yang DZ,et al.Prevalence of polycystic ovary syndrome in women in China:a large community-based study[J].Human Reproduction,2013,28(9):2562-2569.
[2]Moran LJ,Hutchison SK,Norman RJ,et al.Lifestyle changes in women with polycysticovary syndrome[J].Cochrane Database of Systematic Reviews,2011,2(2):1447-1447.
[3]Fauser BC,Tarlatzis BC,Rebar RW,et al.Consensuson women's health aspects of polycystic ovary syndrome(PCOS):the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group[J].Fertil Steril,2012,97(1):28-38.
[4]Qin JZ,Li HP,Mu JL,et al.Obstetric complications in women with polycystic ovary syndrome:a systematic review and meta-analysis[J].Reproductive Biology&Endocrinology Rb&E,2013,11(1):56.
[5]Mu Y,Liu JJ,Wang BB,et al.Interleukin 1 beta(IL-1β)promoter C[-511]T polymorphism but not CT polymorphism is associated with polycystic ovary syndrome[J].Endocrine,2010,37(1):71-75.
[6]Deeks AA,Gibson-Helm ME,Teede HJ.Anxiety and depressionin polycystic ovary syndrome:a comprehensive investigation[J].Fertil Steril,2010,93(7):2421-2423.
[7]Johnson NP.Metformin use in women with polycystic ovary syndrome[J].The Journal of Annals of Translational Medicine,2014,2(6):56.
[8]唐念珍,唐成林,杨辉,等.电针对胰岛素抵抗模型大鼠GLUT4和GSK-3βmRNA表达的影响[J].中国组织化学与细胞化学杂志,2014,23(5):394-400.
[9]姜晓琳,褚春莉,闫大晶,等.温针刺结合健脾祛痰法治疗体重正常型多囊卵巢综合征效果及对性激素、胰岛素抵抗的影响[J].解放军医药杂志,2017,29(3):105-109.
[10]Fengxia L,Rui C,Nakagawa A,et al.Low-frequency elec-troacupuncture improves insulin sensitivity in obese diabetic mice through activation of SIRT1/PGC-1αin skeletal muscle[J].Evid Based Complement Alternat,2011(73):5297
[11]刘玲玲,韩东,侯丽辉.针刺治疗肥胖型多囊卵巢综合征患者伴高胰岛素血症和胰岛素抵抗的临床机制探讨[J].针灸临床杂志,2015,31(3):82-84.
[12]Zheng YH,Wang XH,Lai MH,et al.Effectiveness of abdominal acupuncture for patients with obesity-type polycystic ovary syndrome:arandomized controlled trial[J].J Altern Complement Med,2013,19(9):740-745.
[13]苏健,李亚敏,白杰.针药结合对肥胖型多囊卵巢综合征胰岛素抵抗的影响[J].山东中医杂志,2015,34(1):30-32.
[14]周凌云,徐传花,李淑萍.针药结合治疗肥胖型多囊卵巢综合征肾虚痰湿证临床观察[J].上海针灸杂志,2016,35(10):1213-1215.
[15]钟春华,梁宝珠.中药联合针灸疗法治疗多囊卵巢综合征合并不孕的临床疗效[J].海峡药学,2016,28(7):180-181.
[16]肖慧莲,赖胜兰.中药联合针刺治疗多囊卵巢综合征不孕不育42例[J].中国中医药现代远程教育,2014,12(19):129-131.
[17]梁荣伟,刘新雄,李学余,等.穴位针刺及封闭联合辅助生殖技术对PCOS不孕患者卵子成熟度的影响[J].针灸临床杂志,2013,29(3):17-19.
[18]姜朵生,张迎春,吴献群,等.针药联合克罗米芬治疗多囊卵巢综合征导致不孕症:随机对照研究[J].中国针灸,2015,35(2):114-118.
[19]Rubinsztein DC,Codogno P,Levine B.Autophagy modulation as a potential therapeutic target for diverse disease[J].NatRev Drug Discov,2012,11(9):709-730.
[20]罗嘉,宋英伟,徐艳霞,等.ICSI治疗患者卵丘颗粒细胞自噬活性对卵母细胞质量的影响[J].中国妇幼保健,2014,40(29):2198-2201.
[21]Gonzalez CD,Lee MS,Marchetti P.The emerging role ofautophagy in the pathophysiology of diabetes mellitus[J].Autophagy,2011,7(1):2-11.
[22]Zhang N,Cao MM,Liu H,et al.Autophagy regulates insulin resistance following endoplasmic reticulum stress in diabetes[J].J Physiol Biochem,2015,71(2):319-327.
[23]Rezabakhsh A,Cheraghi O,Nourazarian,et al.Type 2 Diabetes Inhibited Human Mesenchymal Stem Cells Angiogenic Response by OverActivity of the Autophagic Pathway[J].J Cell Biochem,2017,118(6):1518-1530.
[24]Liu XL,Yuan HR,Niu YM,et al.The role of AMPK/m TOR/S6K1signaling axis in mediating the physiological process of exercise-induced insulin sensitization in skeletal muscle of C57BL/6 mice[J].Biochim Biophys Acta,2012,1822(11):1716-1726.
[25]Kai Y,Kawano Y,Yamamot H,et al.A possible role for AMP-activated protein kinase activated by metformin and AICAR in human granulosa cells[J].Reproductive Biology and Endocrinology,2015,13(1):1-8.
[26]Shihyin T,Joanna M,Sitzmann,et al.Muscle-specific 4E-BP1 signaling activation improves metabolic parameters during aging and obesity[J].Journal of Clinical Investigation,2015,125(8):2952-2964.
[27]Li X,Cui P,Jiang HY,et al.Reversing the reduced level of endometrial GLUT4 expression in polycystic ovary syndrome:a mechanistic study of metformin action[J].Am J Transl Res,2015,7(3):574-586.
[28]Liu W,Shang G,Yang S,et al.Electroacupuncture protects against ischemic stroke by reducing autophagosome formation and inhibiting autophagy through the m TORC1-ULK1 complex-Beclin1 pathway[J].Int J Mol Med,2016,37(2):309-318.
[29]Guo HD,Zhu J,Tian JX,et al.Electroacupuncture improves memory and protects neurons by regulation of the autophagy pathway in a rat model of Alzheimer's disease[J].Acupuncture in Medicine,2016,34(6):449-456.
[30]晏珺.电针委中穴在模型大鼠腰多裂肌损伤修复过程中对自噬相关蛋白Beclin1,p62的影响[D].北京:北京中医药大学,2018.
[2]Moran LJ,Hutchison SK,Norman RJ,et al.Lifestyle changes in women with polycysticovary syndrome[J].Cochrane Database of Systematic Reviews,2011,2(2):1447-1447.
[3]Fauser BC,Tarlatzis BC,Rebar RW,et al.Consensuson women's health aspects of polycystic ovary syndrome(PCOS):the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group[J].Fertil Steril,2012,97(1):28-38.
[4]Qin JZ,Li HP,Mu JL,et al.Obstetric complications in women with polycystic ovary syndrome:a systematic review and meta-analysis[J].Reproductive Biology&Endocrinology Rb&E,2013,11(1):56.
[5]Mu Y,Liu JJ,Wang BB,et al.Interleukin 1 beta(IL-1β)promoter C[-511]T polymorphism but not CT polymorphism is associated with polycystic ovary syndrome[J].Endocrine,2010,37(1):71-75.
[6]Deeks AA,Gibson-Helm ME,Teede HJ.Anxiety and depressionin polycystic ovary syndrome:a comprehensive investigation[J].Fertil Steril,2010,93(7):2421-2423.
[7]Johnson NP.Metformin use in women with polycystic ovary syndrome[J].The Journal of Annals of Translational Medicine,2014,2(6):56.
[8]唐念珍,唐成林,杨辉,等.电针对胰岛素抵抗模型大鼠GLUT4和GSK-3βmRNA表达的影响[J].中国组织化学与细胞化学杂志,2014,23(5):394-400.
[9]姜晓琳,褚春莉,闫大晶,等.温针刺结合健脾祛痰法治疗体重正常型多囊卵巢综合征效果及对性激素、胰岛素抵抗的影响[J].解放军医药杂志,2017,29(3):105-109.
[10]Fengxia L,Rui C,Nakagawa A,et al.Low-frequency elec-troacupuncture improves insulin sensitivity in obese diabetic mice through activation of SIRT1/PGC-1αin skeletal muscle[J].Evid Based Complement Alternat,2011(73):5297
[11]刘玲玲,韩东,侯丽辉.针刺治疗肥胖型多囊卵巢综合征患者伴高胰岛素血症和胰岛素抵抗的临床机制探讨[J].针灸临床杂志,2015,31(3):82-84.
[12]Zheng YH,Wang XH,Lai MH,et al.Effectiveness of abdominal acupuncture for patients with obesity-type polycystic ovary syndrome:arandomized controlled trial[J].J Altern Complement Med,2013,19(9):740-745.
[13]苏健,李亚敏,白杰.针药结合对肥胖型多囊卵巢综合征胰岛素抵抗的影响[J].山东中医杂志,2015,34(1):30-32.
[14]周凌云,徐传花,李淑萍.针药结合治疗肥胖型多囊卵巢综合征肾虚痰湿证临床观察[J].上海针灸杂志,2016,35(10):1213-1215.
[15]钟春华,梁宝珠.中药联合针灸疗法治疗多囊卵巢综合征合并不孕的临床疗效[J].海峡药学,2016,28(7):180-181.
[16]肖慧莲,赖胜兰.中药联合针刺治疗多囊卵巢综合征不孕不育42例[J].中国中医药现代远程教育,2014,12(19):129-131.
[17]梁荣伟,刘新雄,李学余,等.穴位针刺及封闭联合辅助生殖技术对PCOS不孕患者卵子成熟度的影响[J].针灸临床杂志,2013,29(3):17-19.
[18]姜朵生,张迎春,吴献群,等.针药联合克罗米芬治疗多囊卵巢综合征导致不孕症:随机对照研究[J].中国针灸,2015,35(2):114-118.
[19]Rubinsztein DC,Codogno P,Levine B.Autophagy modulation as a potential therapeutic target for diverse disease[J].NatRev Drug Discov,2012,11(9):709-730.
[20]罗嘉,宋英伟,徐艳霞,等.ICSI治疗患者卵丘颗粒细胞自噬活性对卵母细胞质量的影响[J].中国妇幼保健,2014,40(29):2198-2201.
[21]Gonzalez CD,Lee MS,Marchetti P.The emerging role ofautophagy in the pathophysiology of diabetes mellitus[J].Autophagy,2011,7(1):2-11.
[22]Zhang N,Cao MM,Liu H,et al.Autophagy regulates insulin resistance following endoplasmic reticulum stress in diabetes[J].J Physiol Biochem,2015,71(2):319-327.
[23]Rezabakhsh A,Cheraghi O,Nourazarian,et al.Type 2 Diabetes Inhibited Human Mesenchymal Stem Cells Angiogenic Response by OverActivity of the Autophagic Pathway[J].J Cell Biochem,2017,118(6):1518-1530.
[24]Liu XL,Yuan HR,Niu YM,et al.The role of AMPK/m TOR/S6K1signaling axis in mediating the physiological process of exercise-induced insulin sensitization in skeletal muscle of C57BL/6 mice[J].Biochim Biophys Acta,2012,1822(11):1716-1726.
[25]Kai Y,Kawano Y,Yamamot H,et al.A possible role for AMP-activated protein kinase activated by metformin and AICAR in human granulosa cells[J].Reproductive Biology and Endocrinology,2015,13(1):1-8.
[26]Shihyin T,Joanna M,Sitzmann,et al.Muscle-specific 4E-BP1 signaling activation improves metabolic parameters during aging and obesity[J].Journal of Clinical Investigation,2015,125(8):2952-2964.
[27]Li X,Cui P,Jiang HY,et al.Reversing the reduced level of endometrial GLUT4 expression in polycystic ovary syndrome:a mechanistic study of metformin action[J].Am J Transl Res,2015,7(3):574-586.
[28]Liu W,Shang G,Yang S,et al.Electroacupuncture protects against ischemic stroke by reducing autophagosome formation and inhibiting autophagy through the m TORC1-ULK1 complex-Beclin1 pathway[J].Int J Mol Med,2016,37(2):309-318.
[29]Guo HD,Zhu J,Tian JX,et al.Electroacupuncture improves memory and protects neurons by regulation of the autophagy pathway in a rat model of Alzheimer's disease[J].Acupuncture in Medicine,2016,34(6):449-456.
[30]晏珺.电针委中穴在模型大鼠腰多裂肌损伤修复过程中对自噬相关蛋白Beclin1,p62的影响[D].北京:北京中医药大学,2018.