A potential therapeutic target in traditional Chinese medicine for ulcerative colitis: Macrophage polarization

Abstract

Intestinal macrophages are the main participants of intestinal immune homeostasis and intestinal inflammation. Under different environmental stimuli, intestinal macrophages can be polarized into classical activated pro-inflammatory phenotype (M1) and alternative activated anti-inflammatory phenotype (M2). Its different polarization state is the “guide” to promoting the development and regression of inflammation. Under normal circumstances, intestinal macrophages can protect the intestine from inflammatory damage. However, under the influence of some genetic and environmental factors, the polarization imbalance of intestinal M1/M2 macrophages will lead to the imbalance in the regulation of intestinal inflammation and transform the physiological inflammatory response into pathological intestinal injury. In UC patients, the disorder of intestinal inflammation is closely related to the imbalance of intestinal M1/M2 macrophage polarization. Therefore, restoring the balance of M1/M2 macrophage polarization may be a potentially valuable therapeutic strategy for UC. Evidence has shown that traditional Chinese medicine (TCM) has positive therapeutic effects on UC by restoring the balance of M1/M2 macrophage polarization. This review summarizes the clinical evidence of TCM for UC, the vital role of macrophage polarization in the pathophysiology of UC, and the potential mechanism of TCM regulating macrophage polarization in the treatment of UC. We hope this review may provide some new enlightenment for the clinical treatment, fundamental research, and research and development of new Chinese medicine of UC.

Alleviating effect of Nexrutine on mucosal inflammation in mice with ulcerative colitis: Involvement of the RELA suppression

“…Traditional herbal medicines have been demonstrated as promising complementary or alternative therapeutic regimens for UC. 32,33 Various herbal or plant extracts have exhibited therapeutic effects on UC in several randomized, double-blind clinical studies. For instance, treatment with wheat grass juice (Triticum aestivum) resulted in endoscopic improvement in the majority of patients with active UC, accompanied by reduced DAI and alleviated rectal bleeding.…”

“…Traditional herbal medicines have been demonstrated as promising complementary or alternative therapeutic regimens for UC 32,33 . Various herbal or plant extracts have exhibited therapeutic effects on UC in several randomized, double‐blind clinical studies.…”

Bioinspired and biomimetic strategies for inflammatory bowel disease therapy

“…Macrophages are classified according to their function as those that promote tissue repair and suppress inflammation (M2) and those that promote inflammatory responses (M1), guiding the development and regression of inflammation based on the balance of intestinal M1/M2 macrophages polarization. 85,86 Therefore, the precise regulation of M1/M2 macrophage polarization has been highly investigated as a therapeutic strategy for IBD and is currently widely used in clinical and preclinical studies.…”

Berberine a traditional Chinese drug repurposing: Its actions in inflammation-associated ulcerative colitis and cancer therapy

“…However, it is still difficult to cure because none of the approaches can reverse the colon injury, and a proportion of patients will have recurrent attacks once ceasing the treatments ( 21 ). Emerging evidence suggests that traditional Chinese medicine has positive clinical outputs for UC, including reducing recurrent diarrhea, ameliorating intestinal inflammatory responses, and improving the patient’s life quality ( 22 , 23 ). Given that BBR has a long history in Chinese medicine used as an antibacterial agent to treat dysentery, it is promising to repurpose BBR for UC and other inflammatory-associated diseases.…”

“…Therefore, it plays a dominant role in UC pathogenesis and regulation. In this regard, maintaining macrophage polarization homeostasis is critical for UC treatment ( 22 ). It is worth mentioning that BBR has been validated to target macrophage polarization and its downstream regulation in health and inflammation; therefore could be a potential therapeutic approach for UC ( 20 , 39 , 40 ).…”