细胞凋亡在动脉粥样硬化斑块形成中的机制及中医药干预策略OA

Atherosclerosis(AS)serves as the core pathological basis of cardiovascular diseases.Atherosclerosis(AS)constitutes the core pathological basis of cardiovascular diseases.Acute events triggered by plaque destabilization pose a serious threat to human health.The pathogenesis of AS is complicated and involves lipid deposition,inflammatory infiltration,abnormal cell apoptosis and other factors.Differential apoptosis of vascular endothelial cells,smooth muscle cells and macrophages acts as a key factor for plaque forma-tion and destabilization.Based on the principle of"disease-syndrome combination",this paper systematically interprets the correlation between the pathogenesis of"collateral injury induced by phlegm-stasis-toxin"and cell apoptosis:Apoptosis of endothelial cells disrupts the vascular barrier and facilitates lipid infiltration,which corresponds to"stasis obstructing collaterals"and the initiation of inflamma-tion;apoptosis of vascular smooth muscle cells thins the fibrous cap and predisposes plaques to rupture,corresponding to"deficiency-in-duced instability of healthy qi"and plaque destabilization;apoptosis of macrophages triggers secondary necrosis and generates the nec-rotic core of advanced-stage atherosclerotic lesions,corresponding to"toxin-induced collateral injury"and inflammatory cascade.The three processes synergistically accelerate the progression of AS.In addition,TCM therapeutic strategies including activating blood circu-lation to resolve stasis,eliminating phlegm to unblock collaterals,and strengthening healthy qi to consolidate the root are proposed to regulate the dynamic balance of apoptosis and stabilize plaques via a multi-component,multi-target and multi-pathway mode,thereby re-vealing the scientific connotation of"strengthening healthy qi and eliminating pathogenic factors to balance apoptosis"in TCM.Never-theless,current studies still have limitations:most studies focus on a single signaling pathway or target,lacking systematic interpretation of the holistic pathogenesis of"phlegm-stasis-toxin injury",and sufficient evidence for clinical translation is absent.Therefore,future re-search should adopt cutting-edge technologies such as single-cell sequencing and spatial transcriptomics to deeply decipher the interac-tive mechanisms of cell apoptosis.High-quality clinical trials should be carried out to establish an efficacy evaluation system compatible with TCM pathogenesis characteristics,promote the transformation of AS research from mechanistic exploration to precise intervention,and provide integrated Chinese-Western medicine strategies for the prevention and treatment of cardiovascular diseases.