标题：桦木酸抗纤维化作用及其机制研究进展

      作者：令狐飞飞 综述 赵勇 审校    遵义医科大学第一附属医院呼吸与危重症科，贵州 遵义 563000

      卷次： 2023年34卷2期

      【摘要】 五环三萜类化合物广泛存在于自然界，如齐墩果酸，是目前被批准在中国治疗肝纤维化疾病如急慢性肝炎的五环三萜类化合物，其能够降低患者血清肝酶，延缓肝纤维化进展。中药活性成分是研究热点，桦木酸(betulinic acid，BA) 又称为白桦酸，是一种羽扇豆烷型五环三萜类化合物，广泛存在于植物中，目前已经发现BA有着多种较强的生物活性，如抗癌、抗炎、抗氧化应激、抗菌、免疫调节、抗寄生虫、抗溃疡及抗疟疾等。组织器官纤维化是临床常见疾病的最终病理表现，严重危害人们的健康，死亡率高、预后差，且目前没有靶向完全逆转纤维化疾病药物。BA先天具有多重药理作用，近来有证据显示BA兼顾着抗纤维化作用，甚至在肺纤维化模型研究中BA疗效优于一线治疗药物吡非尼酮，表明其很可能是治疗纤维化疾病的新星。本文对BA抗纤维化作用及其机制进行简要综述，为未来纤维化疾病药物治疗提供一种新的选择。
      【关键词】 桦木酸；五环三萜；纤维化；炎症；氧化应激；上皮间质转化
      【中图分类号】 R313 【文献标识码】 A 【文章编号】 1003—6350（2023）02—0295—05

Research progress on anti-fibrotic effect and mechanism of betulinic acid.
LINGHU Fei-fei, ZHAO Yong.Department of Respiratory and Critical Care, the First Affiliated Hospital of Zunyi Medical University, Zunyi 563000,Guizhou, CHINA【Abstract】 Pentacyclic triterpenoids are widely found in nature, such as oleanolic acid, which is currently ap-proved in China to treat liver fibrosis diseases such as acute and chronic hepatitis. It can reduce serum liver enzymes anddelay the progression of liver fibrosis. The active ingredient of traditional Chinese medicine is a research hotspot. Betu-linic acid (BA) is a lupin-type pentacyclic triterpenoid, which is widely found in plants. It has been found that BA has avariety of strong biological activities, such as anticancer, anti-inflammatory, anti-oxidative stress, antibacterial, immuno-modulatory, antiparasitic, antiulcer and antimalarial effects. Tissue and organ fibrosis is the final pathological manifesta-tion of common clinical diseases, seriously endangering people's health, with high mortality and poor prognosis, andthere are currently no targeted drugs to completely reverse fibrotic diseases. BA innately has multiple pharmacologicaleffects. Recently, evidence has shown that BA has both anti-fibrotic effects. Even in the model study of pulmonary fibro-sis, the efficacy of BA is better than that of the first-line treatment drug pirfenidone, indicating that it is likely to be anew star in the treatment of fibrotic diseases. This paper briefly reviews the anti-fibrotic effect of BA and its mechanism,and provides a new option for the future drug treatment of fibrotic diseases.
      【Key words】 Betulinic acid; Pentacyclic triterpenes; Fibrosis; Inflammation; Oxidative stress; Epithelial-mesen-chymal transition　　　·综述·doi:10.3969/j.issn.1003-6350.2023.02.034基金项目：贵州省遵义市红花岗区科技局[编号：遵市科合HZ字(2020)245号]。第一作者：令狐飞飞(1995—)，女，住院医师，主要研究方向为间质性肺疾病。