胃癌前病变中有氧糖酵解的作用机制及中医药干预研究进展OA

Gastric precancerous lesions are a key reversible stage in gastric carcinogenesis,and their progression is closely associated with the aberrant activation of aerobic glycolysis.Aerobic glycolysis drives the generation of lactic acid and the formation of an acidic microenvironment by regulating key metabolic enzymes and upstream signaling pathways,thereby promoting the progression of gastric precancerous lesions.Traditional Chinese medicine(TCM),with its advantages of"holistic regulation and multi-target intervention",has shown great potential in regulating aerobic glycolysis and reversing gastric precancerous lesions.This study systematically reviews the molecular mechanisms of aerobic glycolysis in gastric precancerous lesions and the progress of TCM intervention.It is found that TCM monomers and compound formulas can synergistically regulate multiple aspects of the process.They can effectively inhibit the accumulation of lactic acid and the formation of an acidic microenvironment by multi-target regulation of key glycolytic enzymes(such as glucose transporter 1,hexokinase 2,pyruvate kinase M2,and lactate dehydrogenase A)and upstream signaling pathways[such as hypoxia-inducible factor-1α and phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt)/mammalian target of rapamycin(mTOR)],thereby reversing the lesion process.Their mechanisms of action are consistent with the pathogenesis of"spleen deficiency,blood stasis,and toxic damage"in TCM,demonstrating the scientific combination of traditional syndrome-based treatment and modern metabolic regulation mechanisms.