Regulation of Nrf2 Pathway by Traditional Chinese Medicine in Prevention and Treatment of Alzheimer's Disease： A Review / 中国实验方剂学杂志

ABSTRACT

Alzheimer's disease （AD） is a neurodegenerative disease characterized by a progressive decline in memory and cognitive function. β-amyloid protein （Aβ） aggregation and excessive phosphorylation of Tau protein in the brain can increase oxidative stress levels， leading to energy metabolism imbalance， extensive apoptosis of nerve cells， and damage to synaptic function. The nuclear factor E2 related factor 2 （Nrf2） encoded by the Nfe212 gene is known as the "main regulatory factor" of antioxidant response. On the one hand， It can activate antioxidant response elements， such as heme oxygenase-1 （HO-1） and NAD（P）H quinone oxidoreductase1 （NQO1）， increase the expression of antioxidant enzymes glutathione S-transfer （GST） and superoxide dismutase 1 （SOD1）， and reduce the release of reactive oxygen species. On the other hand， it can inhibit immune inflammation， cell apoptosis， and activation of autophagy pathways and delay the progression of AD. Therefore， this article summarized， analyzed， and reviewed the relevant research on the regulation of the Nrf2 signaling pathway by traditional Chinese medicine in the prevention and treatment of AD in the past five years， including its structural characteristics， pathway conduction， mechanism of action in AD， and drug regulation. The results showed that among all reports， research on traditional Chinese medicine compounds occupied a high proportion and mostly focused on flavonoids， with the Nrf2/HO-1 and PI3K/Nrf2 signaling pathways being the most extensively studied. The mechanisms of action were mainly to inhibit oxidative stress， neuroinflammation， and cell apoptosis and improve synaptic function. This indicates that traditional Chinese medicine can regulate multiple Nrf2 signaling pathways and play a role in preventing and treating Alzheimer's disease from multiple mechanisms.