巨噬细胞极化在肾纤维化中的作用与调控机制及中医药干预研究进展OA

Renal fibrosis(RF)is a common pathological fea-ture of chronic kidney disease progressing to end-stage renal dis-ease,mainly characterized by abnormal extracellular matrix(ECM)deposition,renal structural destruction and functional disorder.Imbalanced macrophage polarization acts as a key driving factor in this process.In the injured renal microenviron-ment,macrophages polarize into the M1 phenotype(pro-inflammatory)and the M2 phenotype(anti-inflammatory and pro-fibrotic).M1 macrophages initiate inflammation and induce early renal injury,while M2 macrophages mediate tissue repair and promote excessive ECM deposition.The imbalance between the two phenotypes continuously promotes the progression of RF.Multiple signaling pathways,including TGF-β/Smad,JAK/STAT and NF-κB,as well as metabolic reprogramming,epigen-etic regulation and gut microbiota dysbiosis,are involved in regulating macrophage polarization.With the advantages of multi-component and multi-target effects,traditional Chinese medicine(TCM)can regulate the M1/M2 balance by interven-ing in the above pathways through herbal monomers and com-pound prescriptions,thereby inhibiting inflammation and fibro-sis,showing promising therapeutic potential.This paper sys-tematically reviews the role of macrophage polarization in RF and its regulatory mechanisms and research advances in TCM intervention,so as to provide a theoretical basis and research ideas for TCM prevention and treatment of RF.