Article(id=1322927033210253747, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926740955341011, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.10.029, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339983513, onlineDateStr=2026-10-30, pubDate=1760025600000, pubDateStr=2025-10-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339983513, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339983513, creator=13701087609, updateTime=1793339983513, updator=13701087609, issue=Issue{id=1322926740955341011, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='10', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1760025600000', pubDateStr='2025-10-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339913834, creator='13701087609', updateTime=1793340753123, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322930261259846420, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926740955341011, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322930261259846421, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926740955341011, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=155, endPage=160, ext={EN=ArticleExt(id=1322927033419968948, articleId=1322927033210253747, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Research Progress on Anti-Angiogenesis and Anti-Tumor of Natural Compounds by Inhibiting VEGF, columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=

Malignant tumor is a disease that seriously endangers human health.Angiogenesis is one of the important mechanisms of the occurrence and development of malignant tumors.Vascular endothelial growth factor(VEGF)is widely regarded as the main regulator of angiogenesis and plays an extremely important role in the process of angiogenesis.Targeting VEGF and vascular endothelial growth factor receptor(VEGFR)can reduce angiogenesis in tumor and help to inhibit tumor invasion,proliferation and metastasis,which is one of the important fields of medical research.Natural compounds are widely defined as chemical substances produced by organisms,which have unique chemical diversity,wide sources,multi-targets,multi-mechanisms,multi-channels,low toxic and side effects.Modern studies have confirmed that natural compounds exert an anti-tumor effect on inhibiting angiogenesis by inhibiting VEGF,and natural compounds have obvious therapeutic advantages for malignant tumors,which can effectively inhibit the occurrence and development of tumors and improve the quality of life of cancer patients.In this paper,the related research of natural compounds on anti-angiogenesis and anti-tumor through inhibiting VEGF was summarized,and the main mechanism of VEGF/VEGFR signaling pathway was combed,so as to provide reference for the optimization of clinical malignant tumor treatment strategy.

, authors=Ningning ZHAO1, 2, Yiyang HU1, 2, Yingying XIE1, 2, Chunzheng MA1, Peimin LIU1, Dongdong LI1, Juan ZHANG1, 2, authorsList=Ningning ZHAO, Yiyang HU, Yingying XIE, Chunzheng MA, Peimin LIU, Dongdong LI, Juan ZHANG, authorCompany=null, correspAuthors=Dongdong LI, Juan ZHANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322927033990394295, articleId=1322927033210253747, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=天然化合物通过抑制VEGF抗血管生成抗肿瘤的研究进展, columnId=1256183362172142382, journalTitle=中华中医药学刊, columnName=国家项目点击, runingTitle=null, highlight=null, articleAbstract=

恶性肿瘤是严重危害人类身体健康的疾病。血管生成是恶性肿瘤发生发展的重要机制之一,血管内皮生长因子(vascular endothelial growth factor,VEGF)被广泛认为是血管生成的主要调节因子,在血管生成过程中发挥极其重要的作用。靶向VEGF及血管内皮生长因子受体(vascular endothelial growth factor receptor,VEGFR)可减少肿瘤内血管的新生,有助于抑制肿瘤的侵袭、增殖和转移,是目前医学研究热点的重要领域之一。天然化合物被广泛定义为由生物体产生的化学物质,其拥有独特的化学多样性,来源广泛,具有多靶点、多机制、多途径及不良反应小等特点。现代研究证实,天然化合物可通过抑制VEGF抗血管生成发挥抗肿瘤的作用,且治疗优势显著,可有效抑制肿瘤发生发展及改善患者生存质量。将天然化合物通过抑制VEGF抗血管生成抗肿瘤的相关研究进行归纳总结,梳理VEGF/VEGFR信号通路主要作用机制,以期为临床恶性肿瘤治疗策略的优化提供借鉴与参考。

, authors=赵宁宁1, 2, 胡亦杨1, 2, 谢瑛莹1, 2, 马纯政1, 刘培民1, 李东东1, 张娟1, 2, authorsList=赵宁宁, 胡亦杨, 谢瑛莹, 马纯政, 刘培民, 李东东, 张娟, authorCompany=null, correspAuthors=李东东, 张娟, authorNote=

赵宁宁(1998-),女,河南周口人,硕士在读,研究方向:中医药防治恶性肿瘤的临床及基础研究。

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张娟(1982-),女,河南安阳人,副教授,硕士研究生导师,博士,研究方向:中医药防治恶性肿瘤的临床及基础研究。E-mail:。
李东东(1989-),男,河南开封人,主治医师,博士,研究方向:中医药防治恶性肿瘤的临床及基础研究。E-mail:。
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赵宁宁(1998-),女,河南周口人,硕士在读,研究方向:中医药防治恶性肿瘤的临床及基础研究。

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类别名称来源抑制VEGF方式作用肿瘤参考文献
生物碱类槐果碱sophora herb下调VEGF-A及抑制VEGF通路结直肠癌[24]
马钱子碱马钱子下调VEGF乳腺癌[25]
荜茇明碱荜茇下调VEGF肺癌[26]
白屈菜碱白屈菜减少VEGF表达肺癌[27]
川芎嗪川芎上调KLF4表达,进而下调VEGF的表达肝癌[28]
紫杉醇短叶红豆杉降低VEGF卵巢癌[29]
萜类紫丁香苷刺五加、丁香等靶向VEGFR2,抑制VEGF与VEGFR2的结合[30]
穿心莲内酯穿心莲抑制VEGF信号通路乳腺癌[31]
土槿皮乙酸土槿皮降低VEGF和VEGF的蛋白表达或在CD147敲低后降低VEGF-A的表达食管癌[32]
地榆皂苷ⅡSanguisorba officinalis L通过阻断AKT信号通路显著降低VEGF或bFGF诱导的ERK磷酸化[33]
皂苷类人参皂苷Rg3人参下调VEGF蛋白表达肝癌[34]
重楼皂苷Ⅰ重楼靶向VEGF-A肺腺癌[35]
重楼皂苷Ⅱ重楼抑制VEGF[36]
人参皂苷Rd人参抑制VEGF[37]
黄芪皂苷黄芪抑制HIF-1α/VEGF信号通路肺腺癌[38]
茶树种子总皂苷茶树种子通过HIF-1α依赖性途径降低VEGF蛋白表达卵巢癌[39]
桔梗皂苷桔梗通过MAPK通路抑制VEGF,或抑制VEGF通路[40-41]
麦冬皂苷B麦冬抑制VEGFR2通路,降低VEGF-A的表达肺腺癌,肝癌[42-43]
黄酮类黄芩素黄芩与TLR4结合,下调HIF-1α及VEGF蛋白表达结直肠癌[44]
漆黄素洋葱、黄瓜和草莓等通过上调AKAP12显著降低VEGF水平结直肠癌[45]
异甘草素甘草通过AKT信号通路下调VEGF表达神经胶质瘤[46]
金合欢素广泛存在于金合欢树、刺槐、菊花等植物降低HIF-1α及VEGF蛋白表达胆囊癌[47]
荔枝核总黄酮荔枝核降低VEGF表达直肠癌[48]
酚类姜黄素姜黄、菖蒲、郁金等通过抑制NF-κB下调VEGF及其下游因子Notch和HIF-1的表达,还
可通过上调肝癌细胞miR-29表达进而下调VEGF表达
肺癌,肝癌[49-50]
丹参素丹参抑制VEGF表达水平肺癌[51]
白藜芦醇多存在于虎杖、葡萄、蓝莓、覆盆子等植物抑制HIF-1α和VEGF通路非小细胞肺癌[52]
槲皮素洋葱、茶和葡萄酒等降低VEGF-A表达食管癌[53]
醌类丹参酮ⅡA丹参抑制VEGFR/AKT通路非小细胞肺癌[54]
大黄素多存在于大黄、虎杖、何首乌等增加SerRS的表达,从而降低VEGF-A转录,以及通过降低HIF-1α
mRNA的表达水平,进而下调VEGF mRNA的表达
三阴性乳腺癌,肝癌[55-56]
白花丹素白花丹抑制SDF-1诱导的VEGF活化肝癌[57]
多糖类黄芪多糖黄芪抑制VEGF表达肺癌[58]
半枝莲多糖半枝莲下调VEGF mRNA和蛋白表达水平肝癌[59]
其他天然化合物蟾毒灵蟾酥通过抑制STAT3信号通路,下调VEGF结直肠癌[60]
辣椒素辣椒通过抑制COX-2的表达抑制HIF-1α的核定位,从而下调VEGF的表达非小细胞肺癌[61]
五味子乙素北五味子抑制VEGF-A肝癌[62]
白花丹醌白花丹抑制VEGF、VEGFR2结肠癌[63]
龙胆苦苷龙胆草、秦艽抑制VEGF肝癌[64]
水飞蓟宾水飞蓟素下调VEGF结直肠癌[65]
), ArticleFig(id=1322927037270340082, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927033210253747, language=CN, label=表1, caption=

通过抑制VEGF抗血管生成途径抗肿瘤天然化合物总结

, figureFileSmall=null, figureFileBig=null, tableContent=
类别名称来源抑制VEGF方式作用肿瘤参考文献
生物碱类槐果碱sophora herb下调VEGF-A及抑制VEGF通路结直肠癌[24]
马钱子碱马钱子下调VEGF乳腺癌[25]
荜茇明碱荜茇下调VEGF肺癌[26]
白屈菜碱白屈菜减少VEGF表达肺癌[27]
川芎嗪川芎上调KLF4表达,进而下调VEGF的表达肝癌[28]
紫杉醇短叶红豆杉降低VEGF卵巢癌[29]
萜类紫丁香苷刺五加、丁香等靶向VEGFR2,抑制VEGF与VEGFR2的结合[30]
穿心莲内酯穿心莲抑制VEGF信号通路乳腺癌[31]
土槿皮乙酸土槿皮降低VEGF和VEGF的蛋白表达或在CD147敲低后降低VEGF-A的表达食管癌[32]
地榆皂苷ⅡSanguisorba officinalis L通过阻断AKT信号通路显著降低VEGF或bFGF诱导的ERK磷酸化[33]
皂苷类人参皂苷Rg3人参下调VEGF蛋白表达肝癌[34]
重楼皂苷Ⅰ重楼靶向VEGF-A肺腺癌[35]
重楼皂苷Ⅱ重楼抑制VEGF[36]
人参皂苷Rd人参抑制VEGF[37]
黄芪皂苷黄芪抑制HIF-1α/VEGF信号通路肺腺癌[38]
茶树种子总皂苷茶树种子通过HIF-1α依赖性途径降低VEGF蛋白表达卵巢癌[39]
桔梗皂苷桔梗通过MAPK通路抑制VEGF,或抑制VEGF通路[40-41]
麦冬皂苷B麦冬抑制VEGFR2通路,降低VEGF-A的表达肺腺癌,肝癌[42-43]
黄酮类黄芩素黄芩与TLR4结合,下调HIF-1α及VEGF蛋白表达结直肠癌[44]
漆黄素洋葱、黄瓜和草莓等通过上调AKAP12显著降低VEGF水平结直肠癌[45]
异甘草素甘草通过AKT信号通路下调VEGF表达神经胶质瘤[46]
金合欢素广泛存在于金合欢树、刺槐、菊花等植物降低HIF-1α及VEGF蛋白表达胆囊癌[47]
荔枝核总黄酮荔枝核降低VEGF表达直肠癌[48]
酚类姜黄素姜黄、菖蒲、郁金等通过抑制NF-κB下调VEGF及其下游因子Notch和HIF-1的表达,还
可通过上调肝癌细胞miR-29表达进而下调VEGF表达
肺癌,肝癌[49-50]
丹参素丹参抑制VEGF表达水平肺癌[51]
白藜芦醇多存在于虎杖、葡萄、蓝莓、覆盆子等植物抑制HIF-1α和VEGF通路非小细胞肺癌[52]
槲皮素洋葱、茶和葡萄酒等降低VEGF-A表达食管癌[53]
醌类丹参酮ⅡA丹参抑制VEGFR/AKT通路非小细胞肺癌[54]
大黄素多存在于大黄、虎杖、何首乌等增加SerRS的表达,从而降低VEGF-A转录,以及通过降低HIF-1α
mRNA的表达水平,进而下调VEGF mRNA的表达
三阴性乳腺癌,肝癌[55-56]
白花丹素白花丹抑制SDF-1诱导的VEGF活化肝癌[57]
多糖类黄芪多糖黄芪抑制VEGF表达肺癌[58]
半枝莲多糖半枝莲下调VEGF mRNA和蛋白表达水平肝癌[59]
其他天然化合物蟾毒灵蟾酥通过抑制STAT3信号通路,下调VEGF结直肠癌[60]
辣椒素辣椒通过抑制COX-2的表达抑制HIF-1α的核定位,从而下调VEGF的表达非小细胞肺癌[61]
五味子乙素北五味子抑制VEGF-A肝癌[62]
白花丹醌白花丹抑制VEGF、VEGFR2结肠癌[63]
龙胆苦苷龙胆草、秦艽抑制VEGF肝癌[64]
水飞蓟宾水飞蓟素下调VEGF结直肠癌[65]
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天然化合物通过抑制VEGF抗血管生成抗肿瘤的研究进展
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赵宁宁 1, 2 , 胡亦杨 1, 2 , 谢瑛莹 1, 2 , 马纯政 1 , 刘培民 1 , 李东东 1 , 张娟 1, 2
中华中医药学刊 | 国家项目点击 2025,43(10): 155-160
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中华中医药学刊 |国家项目点击 2025 , 43 (10) : 155 -160
天然化合物通过抑制VEGF抗血管生成抗肿瘤的研究进展
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赵宁宁(1998-),女,河南周口人,硕士在读,研究方向:中医药防治恶性肿瘤的临床及基础研究。

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赵宁宁(1998-),女,河南周口人,硕士在读,研究方向:中医药防治恶性肿瘤的临床及基础研究。

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赵宁宁1, 2, 胡亦杨1, 2, 谢瑛莹1, 2, 马纯政1, 刘培民1, 李东东1 , 张娟1, 2
作者信息
  • 1.河南中医药大学第二附属医院,河南 郑州 450002
  • 2.河南中医药大学第二临床医学院,河南 郑州 450046
通讯作者:
张娟(1982-),女,河南安阳人,副教授,硕士研究生导师,博士,研究方向:中医药防治恶性肿瘤的临床及基础研究。E-mail:。
李东东(1989-),男,河南开封人,主治医师,博士,研究方向:中医药防治恶性肿瘤的临床及基础研究。E-mail:。
作者简介:

赵宁宁(1998-),女,河南周口人,硕士在读,研究方向:中医药防治恶性肿瘤的临床及基础研究。

Research Progress on Anti-Angiogenesis and Anti-Tumor of Natural Compounds by Inhibiting VEGF
Ningning ZHAO1, 2, Yiyang HU1, 2, Yingying XIE1, 2, Chunzheng MA1, Peimin LIU1, Dongdong LI1 , Juan ZHANG1, 2
Affiliations
  • 1.The Second Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450002,Henan,China
  • 2.The Second Clinical Medical College of Henan University of Chinese Medicine,Zhengzhou 450046,Henan,China
出版时间: 2025-10-10 doi: 10.13193/j.issn.1673-7717.2025.10.029
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恶性肿瘤是严重危害人类身体健康的疾病。血管生成是恶性肿瘤发生发展的重要机制之一,血管内皮生长因子(vascular endothelial growth factor,VEGF)被广泛认为是血管生成的主要调节因子,在血管生成过程中发挥极其重要的作用。靶向VEGF及血管内皮生长因子受体(vascular endothelial growth factor receptor,VEGFR)可减少肿瘤内血管的新生,有助于抑制肿瘤的侵袭、增殖和转移,是目前医学研究热点的重要领域之一。天然化合物被广泛定义为由生物体产生的化学物质,其拥有独特的化学多样性,来源广泛,具有多靶点、多机制、多途径及不良反应小等特点。现代研究证实,天然化合物可通过抑制VEGF抗血管生成发挥抗肿瘤的作用,且治疗优势显著,可有效抑制肿瘤发生发展及改善患者生存质量。将天然化合物通过抑制VEGF抗血管生成抗肿瘤的相关研究进行归纳总结,梳理VEGF/VEGFR信号通路主要作用机制,以期为临床恶性肿瘤治疗策略的优化提供借鉴与参考。

天然化合物  /  恶性肿瘤  /  VEGF  /  血管生成  /  研究进展

Malignant tumor is a disease that seriously endangers human health.Angiogenesis is one of the important mechanisms of the occurrence and development of malignant tumors.Vascular endothelial growth factor(VEGF)is widely regarded as the main regulator of angiogenesis and plays an extremely important role in the process of angiogenesis.Targeting VEGF and vascular endothelial growth factor receptor(VEGFR)can reduce angiogenesis in tumor and help to inhibit tumor invasion,proliferation and metastasis,which is one of the important fields of medical research.Natural compounds are widely defined as chemical substances produced by organisms,which have unique chemical diversity,wide sources,multi-targets,multi-mechanisms,multi-channels,low toxic and side effects.Modern studies have confirmed that natural compounds exert an anti-tumor effect on inhibiting angiogenesis by inhibiting VEGF,and natural compounds have obvious therapeutic advantages for malignant tumors,which can effectively inhibit the occurrence and development of tumors and improve the quality of life of cancer patients.In this paper,the related research of natural compounds on anti-angiogenesis and anti-tumor through inhibiting VEGF was summarized,and the main mechanism of VEGF/VEGFR signaling pathway was combed,so as to provide reference for the optimization of clinical malignant tumor treatment strategy.

natural compounds  /  malignant tumor  /  VEGF  /  angiogenesis  /  research progress
赵宁宁, 胡亦杨, 谢瑛莹, 马纯政, 刘培民, 李东东, 张娟. 天然化合物通过抑制VEGF抗血管生成抗肿瘤的研究进展. 中华中医药学刊, 2025 , 43 (10) : 155 -160 . DOI: 10.13193/j.issn.1673-7717.2025.10.029
Ningning ZHAO, Yiyang HU, Yingying XIE, Chunzheng MA, Peimin LIU, Dongdong LI, Juan ZHANG. Research Progress on Anti-Angiogenesis and Anti-Tumor of Natural Compounds by Inhibiting VEGF[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (10) : 155 -160 . DOI: 10.13193/j.issn.1673-7717.2025.10.029
在全球范围内,恶性肿瘤发病率和病死率高,严重危害人类身体健康[1-3]。手术治疗、放射治疗和化学治疗作为目前癌症的常规治疗方法,虽然效果显著,但手术创伤、药物不良反应和耐药性的存在严重影响患者的治疗依从性、生活质量和治疗效果[4-5],故恶性肿瘤治疗方案的优化和靶点的发现势在必行。现代研究发现,血管生成为癌细胞的侵袭转移和增殖创造有利条件[6],血管内皮生长因子(vascular endothelial growth factor,VEGF)被广泛认为是血管生成的主要调节因子,在调节血管生成中起关键作用[7]。天然化合物来源广泛,具有多靶点、多机制、多途径及不良反应小等特点[8-9],可通过抑制VEGF抗血管生成发挥抗肿瘤的作用,对于降低抗肿瘤药物毒性及协同作用方面具有独特优势[10],从中药中筛选和开发的通过抑制VEGF抗血管生成抗肿瘤药物有很大潜力。现将天然化合物通过抑制VEGF抗血管生成抗肿瘤的相关研究进行归纳总结,梳理主要作用机制,以期为临床恶性肿瘤治疗策略的优化提供借鉴与参考。
血管生成过程复杂,与多种因子相关,如VEGF、血小板衍生生长因子(platelet-derived growth factor,PDGF)、成纤维细胞生长因子(fibroblast growth factor,FGF)等,其中,VEGF是一种血管内皮细胞关键生存因子和有丝分裂原,被广泛认为是血管生成的主要调节因子[7],VEGF家族由VEGF-A、VEGFB、VEGF-C、VEGF-D和胎盘生长因子(placental growth factor,PIGF)5种分泌蛋白组成,其通过与氨酸激酶受体结合来实现细胞内的信号转导。由于VEGF-A在调节血管生成和疾病中的主导作用,因此VEGF通常指的是VEGF-A,在缺氧条件下,缺氧诱导因子-1α(hypoxia-inducible factor-1α,HIF-1α)可以上调VEGF,VEGF可与血管内皮生长因子受体(vascular endothelial growth factor receptor,VEGFR)1和VEGFR2结合促进血管生成,由于VEGFR2是介导血管内皮细胞中大多数VEGF信号的主要受体,故VEGF主要与VEGFR2结合,促进内皮细胞迁移和有丝分裂。VEGF与VEGFR2结合后,胞内信号转导区的酪氨酸随即发生磷酸化,一是可以激活Raf激酶-丝裂原活化的细胞外信号调节激酶(mitogen-activated extracellular signal-regulated kinase,MEK)-丝裂原活化蛋白激酶(mitogen-activated protein kinase,MAPK)通路,促进内皮细胞增殖;二是可以激活磷脂酰肌醇3激酶-蛋白激酶B信号通路(PI3K-AKT signaling pathway,PI3K/AKT),促进内皮细胞存活及增加血管通透性,同时,也可以激活p38 MAPK信号,进而触发肌动蛋白重组并促进内皮细胞的迁移。各通路的激活共同促进细胞分裂增殖、血管通透性增加及血管重构[11-12],进而促进肿瘤生长和进展。因此,抑制肿瘤血管生成的关键在于阻断VEGF与VEGFR结合或下调其两者表达[13]。见插页ⅩⅩⅣ图1。
恶性肿瘤的发生与体细胞发生“意外”的突变、抑癌基因的功能失活突变(loss-of-function,LOH)和原癌基因的功能获得突变(gain-of-function,GOF)、上皮防御癌症能力及与血液系统建立联系密切相关。其中,建立肿瘤自身的血管系统、连接血液循环是肿瘤生长和转移的前提,这不仅可以为肿瘤细胞供氧,同时也可以源源不断将血液中的营养物质输送给克隆内部的肿瘤细胞,此外,肿瘤血管还可以不断地将癌细胞输送给新的组织和器官,肿瘤的血管生成支撑着几乎所有实体肿瘤的生长和转移[14]。1971年,Jodah Folkman教授提出肿瘤新生血管学说,认为VEGF在调节血管生成中起关键作用,多项研究证实,通过抑制VEGF抗血管生成可引起肿瘤的休眠,抑制肿瘤的发展与转移,肿瘤血管生成后被确认为恶性肿瘤的重要治疗靶点之一,促成后来一系列的抗血管生成药的诞生[15-16]。选择靶向VEGF和VEGFR蛋白的抗体药物、VEGFR-酪氨酸激酶抑制剂(tyrosine kinase inhibitors,TKIs)以及免疫调节剂等,可以阻断VEGF和VEGFR之间相互作用及阻断下游信号转导来抑制肿瘤血管生成,有助于抑制肿瘤增殖、侵袭和转移,从而实现抗肿瘤的目的[17-18]。目前临床上已经有许多抗血管新生单体纳入到对肿瘤的治疗中,例如,贝伐珠单抗(bevacizumab,avastin)于2004年成为FDA批准的首个抗VEGF单克隆抗体,通过竞争性结合VEGF-A,阻止VEGF-A与其受体结合,发挥抑制血管生成抗肿瘤的目的,其被证实在结直肠癌、非小细胞肺癌和乳腺癌中具有较好的临床疗效[19]。常见的VEGFR-TKIs包括阿帕替尼、安罗替尼、尼达尼布、呋喹替尼、索拉非尼等,上述抗血管生成药物与化疗、放疗、免疫抑制剂等治疗手段联用可以增强疗效,发挥协同治疗效果。举例来说,安罗替尼作为中国原研小分子多靶点TKI,可通过靶向VEGFR、血小板衍生生长因子受体(plateletderived growth factor receptor,PDGFR)、成纤维细胞生长因子受体(fibroblast growth factor receptor,FG-FR)及c-Kit等多个靶点,发挥抗肿瘤血管新生及抑制肿瘤生长的双重作用[20],当安罗替尼与PD-1/PD-L1抑制剂联合使用时具有显著的协同治疗效果,可通过抑制AKT通路下调血管内皮细胞上PD-L1表达,调节免疫微环境,发挥对非小细胞肺癌的抗肿瘤疗效[21]。当安罗替尼联合伊立替康治疗小细胞肺癌时可以降低基质金属蛋白酶(matrix metalloproteinase,MMP)2、VEGF、TGF-β1等血清指标,缓解疾病症状与维持病情稳定,且可延长患者生存期,临床效果更好[22]。当安罗替尼联合放疗治疗局部中晚期宫颈鳞癌时安全且肿瘤缓解率好,具有提升肿瘤放疗效果的协同作用[23]。
研究发现槐果碱具有抑制结肠癌细胞增殖和迁移的作用,可以抑制HCT116和SW620细胞上清中VEGF家族细胞因子的分泌,明显下调VEGF-A、VEGF-C、VEGF-D表达水平,进一步探索槐果碱抑制结直肠癌细胞迁移的机制发现,
槐果碱可能通过抑制MEK、细胞外信号调节激酶(extracellular signal-regulated kinase,ERK)和VEGF通路对结直肠癌细胞表现出抗迁移作用[24]。体外实验证实马钱子碱呈剂量和时间依赖的方式抑制乳腺癌MDA-MB-231细胞的生长,促进早期凋亡细胞的增加,且随着浓度的增加,可以减少管道结构形成的数目、节点数及血管分支数,提示马钱子碱可以抑制血管生成拟态的形成,其机制可能与马钱子碱下调VEGF、血管内皮钙黏蛋白(vascular endothelial cadherin,VE-cadherin)、促红细胞生成素产生肝细胞受体A2(Erythropoietin-producing hepatocellular A2,EphA2)、MMP-9及MMP-2等的表达有关[25]。荜茇明碱可作用于Lewis肺癌小鼠发挥抗肿瘤生长的作用,不仅能够显著下调血清中VEGF和TGF-β1的水平,而且可以降低肿瘤组织中TGF-β1、ERK1/2、MEK、p-ERK1/2的蛋白表达,从而发挥抗肿瘤血管生成和迁移的作用[26]。白屈菜碱可以减少肺癌移植瘤小鼠肿瘤组织的VEGF表达,降低该小鼠模型的微血管密度,从而阻断血管新生达到抗肿瘤作用[27]。川芎嗪被证实对H22肝癌小鼠实体瘤的生长具有一定的抑制作用,作用机制可能与其上调抑癌基因Kruppel样因子(Kruppel-likefactor 4,KLF4)表达,进而下调VEGF表达并且上调含1型凝血酶敏感蛋白基序的解聚素样金属蛋白酶(a disintegrin and metalloproteinase with thrombospondin motifs 1,ADAMTS1)表达,进而抑制肿瘤血管生成有关[28]。白蛋白结合型紫杉醇和紫杉醇都可以降低VEGF、MMP的表达,且前者优于后者,考虑白蛋白结合型紫杉醇以人血白蛋白为载体,可通过进入微血管与蛋白二聚体结合而稳定微血管,发挥降低新血管形成及肿瘤转移的作用[29]。
研究发现紫丁香苷具有抗血管生成活性,反向分子对接研究显示紫丁香苷可能是通过抑制二氢叶酸还原酶(dihydrofolate reductase,DHFR)、VEGFR2、TGF-βR1和MMP-2抗血管生成,其中,紫丁香苷与DHFR结合最强,并在一定程度上与TGF-βR1、VEGFR2和MMP-2结合,提示了紫丁香苷是一种多靶点抑制血管新生抗肿瘤的化合物[30]。有研究证实了穿心莲内酯可显著抑制p300 HAT活性,减弱反式激活蛋白的乙酰化和结合,抑制环氧合酶(cyclooxygenase-2,COX-2)的表达,还可抑制VEGF诱导的COX活化,且以剂量依赖性方式抑制VEGF诱导的人脐静脉内皮细胞(human umbilical vein endothelial cells,HUVEC)的迁移和侵袭,从而发挥抑制乳腺癌细胞的增殖和血管生成的作用[31]。土槿皮乙酸在体外可以抑制食管鳞状细胞癌(esophageal squamous cell carcinoma,ESCC)细胞的增殖和侵袭,诱导ESCC细胞凋亡,进一步体内研究发现土槿皮乙酸能够抑制ESCC小鼠的生长,下调MMP-2、MMP-3、MMP-9、Ki67、CD43和VEGF-A蛋白表达,同时,土槿皮乙酸具有抑制内皮细胞迁移的能力,以剂量依赖性方式显著降低HUVEC中VEGF和VEGFR的蛋白表达,此外,土槿皮乙酸在ESCC中的CD147过表达后能够发挥抗肿瘤作用,在CD147敲低后,可以显著降低Ki67、VEGF-A、MMP-2、MMP-3和MMP-9的表达[32]。地榆皂苷Ⅱ可能是通过阻断AKT信号通路显著降低VEGF或bFGF诱导的ERK磷酸化,从而能显著抑制HUVEC的增殖迁移、小管形成及主动脉环微血管的生长[33]。
人参皂苷Rg3呈剂量依赖性方式显著提高肿瘤小鼠的免疫功能及抑制肿瘤血管生成,与顺铂有协同作用,其可能机制是提高CD+3、CD+4水平,降低CD+8水平,进而显著提高肿瘤小鼠的免疫功能,同时下调小鼠肿瘤组织中MMP-2、MMP-9、VEGF蛋白表达量,抑制肿瘤血管微血管密度,从而有效抑制H22肝癌细胞的侵袭转移[34]。王璇等[35]以斑马鱼胚胎为模型,对重楼皂苷I的发育毒性及抗血管新生活性进行研究,在较低质量浓度暴露条件下,重楼皂苷I不会引起斑马鱼肝脏和心脏表型出现明显变化,却能够显著抑制斑马鱼节间血管新生,进一步探究其机制发现,重楼皂苷I的抗血管生成活性系与VEGF-A、EGFR、FGF2等10个关键靶点的调节密切相关。重楼皂苷Ⅱ和人参皂苷Rd均能抑制VEGF诱导的HUVEC的增殖、迁移和成管功能,下调HUVEC自身释放的VEGF水平,抑制VEGF所刺激的病理性血管生成[36-37]。陈静等[38]通过体外实验证实黄芪总皂苷可作用于肺腺癌细胞发挥抗抑制肺腺癌细胞的增殖、迁移及诱导其凋亡的作用,其机制可能与抑制HIF-1α/VEGF信号通路有关。用茶总苷(Tea saponins,TS)干预对铂类耐药卵巢癌细胞OVCAR-3、A2780和CP70的研究发现,TS能够强选择性地抑制人卵巢癌细胞及保留正常细胞,可能通过外源性途径介导细胞凋亡,并通过HIF-1α依赖性途径降低VEGF蛋白表达,从而减少肿瘤诱导的血管新生[39]。体内体外实验证实桔梗皂苷(platycodin D,PD)通过MAPK的激活直接和间接地阻止VEGF及白细胞介素-8(interleukin-8,IL-8)诱导的血管生成[40]。同时,一项在A549细胞中的体外实验表明,PD以剂量和时间依赖的方式调节p53/VEGF/MMP-2通路,抑制A549细胞增殖及诱导细胞凋亡[41]。研究显示麦冬皂苷B(ophiopogeninB,OP-B)通过改善A549细胞之间的紧密蛋白连接,抑制了细胞内的上皮细胞-间充质转化,进而调节了细胞内的EphA2/AKT/Raf/ERK和Src/FAK/信号转导及转录激活因子(signal transducer and activator of transcription,STAT)通路,从而抑制了A549细胞在体外和体内的转移,同时,OP-B通过抑制VEGFR2/酪氨酸激酶受体(tyrosine-protein kinase receptor 2,Tie2)/AKT/PLC和EphA2通路,抑制体内A549肿瘤的血管生成[42]。另外,有研究证实OP-B还可抑制MHCC97-H细胞的迁移、侵袭和血管生成,能显著增加E-钙黏蛋白(E-cadherin,ECad)的表达,同时降低N-钙黏蛋白、波形蛋白和VEGF-A的表达[43]。
体外实验证实黄芩素以剂量依赖的方式直接与人结直肠癌细胞表面Toll样受体4(toll-like receptor 4,TLR4)稳定结合,下调下游信号分子HIF-1α及VEGF蛋白表达,同时体内试验证实黄芩素能降低肿瘤组织中VEGF、CD31和MMP-2的表达,提示黄芩素通过抑制VEGF抑制血管生成[44]。漆黄素能显著抑制结直肠癌患者来源类器官的增殖,通过上调A激酶锚定蛋白12(A-kinase anchoring protein 12,AKAP12)显著降低VEGF水平和上皮细胞黏附分子水平抑制血管生成,从而发挥抗结直肠癌的作用[45]。异甘草素是一种COX-2、膜结合型前列腺素E2合酶-1(microsomal prostaglandin E2 synthase-1,mPGES-1)和细胞色素P450 4A11(CytochromeP450 4A11,CYP4A11)抑制剂,可以通过AKT信号通路下调胶质瘤细胞中FGF-2、TGF-β和VEGF的表达,从而阻断血管生成并诱导神经胶质瘤血管正常化[46]。严培虎等[47]以不同剂量金合欢素处理GBC-SD细胞,能通过降低HIF-1α/VEGF通路蛋白表达而抑制胆囊癌细胞增殖、迁移和侵袭,诱导胆囊癌细胞凋亡,抑制体内外血管生成及体内肿瘤生长。荔枝核总黄酮对直肠癌疗效显著,不仅可以显著降低直肠癌裸鼠瘤体体积,而且能改善微血管密度及降低VEGF表达,从而抑制肿瘤血管新生[48]。
研究发现腹腔注射姜黄素能够通过抑制核因子κB(nuclear factor kappa-B,NF-κB)下调VEGF及其下游因子Notch和HIF-1的表达,从而发挥抑制血管生成抗肺癌的作用[49]。陈彩萍等[50]研究发现姜黄素通过时间及剂量依赖的方式抑制Hep G2细胞,在某种程度上能够上调肝癌细胞miR-29表达进而下调VEGF表达,从而调控肝癌细胞生物学过程。研究发现丹参素能够显著抑制Lewis肺癌小鼠肿瘤组织中VEGF表达水平,促进肿瘤脉管系统重塑,改善微循环,显著降低肿瘤缺氧,且对Lewis肺癌小鼠的放疗具有增敏作用[51]。有研究证实白藜芦醇(resveratrol,RES)通过抑制裸鼠模型中STAT3、HIF-1α和VEGF的表达部分抑制非小细胞肺癌,该研究表明STAT3/HIF-1α/VEGF通路可能裸鼠模型中是开发RES衍生的新化疗药物治疗非小细胞肺癌的候选靶点[52]。研究证实槲皮素可通过降低VEGF-A、MMP-2和MMP-9表达抑制食管癌细胞的侵袭和血管生成[53]。
研究发现丹参酮ⅡA可以通过下调VEGFR/AKT通路增强人非小细胞肺癌细胞对吉非替尼的敏感性,进一步体内研究发现,吉非替尼和丹参酮ⅡA协同使用可以显著降低p-VEGFR和p-AKT表达水平,通过抑制VEGFR/AKT通路抑制非小细胞肺癌小鼠异种移植模型中的肿瘤生长[54]。有研究证实大黄素能显著增加三阴性乳腺癌细胞中的SerRS表达丝氨酰-tRNA合成酶(seryl-tRNA synthetase,SerRS)的表达,从而降低VEGFA转录及抑制三阴性乳腺癌荷瘤小鼠的血管生成[55],也有研究认为,大黄素能够降低HIF-1αmRNA的表达水平,进而下调VEGF mRNA的表达,从而显著抑制人肝癌Hep G2细胞新生血管的形成[56]。体外实验证实白花丹素呈剂量依赖的方式显著抑制PI3K-AKT、CXC型趋化因子受体4(CXC chemokine receptor-4,CXCR4)和CXCR趋化因子受体7(CXC chemokine receptor-7,CXCR7)的过表达,同时抑制基质细胞衍生因子-1(stromal cell-derived factor-1,SDF-1)诱导的VEGF活化,阻止血管生成信号通路的激活,从而抑制肝癌SMMC-7721细胞的增殖和侵袭[57]。
有研究结果表明,黄芪多糖能抑制肺癌组织中VEGF和EGFR的表达,且证实具有浓度效应关系,可以改善免疫器官功能,有效抑制小鼠Lewis肺癌的生长和转移[58]。张玉穗等[59]研究半枝莲多糖不同给药方式对大鼠肝癌模型血管生成的影响发现,半枝莲多糖可具有抑制肝癌组织生长和血管生成的作用,其机制可能与VEGF mRNA和蛋白表达水平的下调有关,且肝动脉灌注的抗肿瘤效果优于口服。
蟾毒灵通过抑制血管内皮细胞中的STAT3信号通路介导VEGF、PDGFA、E-选择素和P-选择素等多种促血管生成因子的下调,从而抑制肿瘤血管新生[60]。辣椒素能够重新激活缺氧非小细胞肺癌细胞中的p53-SMAR1自动调节信号环,其中,p53反式激活了SMAR1,从而稳定了p53,激活的p53通过促进HIF-1α的降解和抑制其转录来下调HIF-1α,此外,p53-SMAR1串扰通过抑制COX-2的表达抑制HIF-1α的核定位,从而下调VEGF的表达,最终抑制非小细胞癌诱导的血管生成[61]。彭朝阳等[62]研究发现五味子乙素可以通过B淋巴细胞瘤-2基因(B-cell lymphoma-2,Bcl-2)/Bcl-2相关蛋白(BCL2-Associated X,bax)介导的信号通路诱导肝癌细胞HCCLM3凋亡,也可通过降低MMP-2和MMP-9表达减弱肝癌细胞HCCLM3细胞侵袭,同时还可抑制血管新生因子VEGF-A、EGF和bFGF表达减少血管新成。韦燕飞等[63]成功建立体外肝癌HepG2细胞缺氧模型,发现白花丹醌在缺氧情况下可以抑制肝癌HepG2细胞的侵袭、增殖,以及诱导细胞凋亡,其机制可能与下调核转录因子c-Myc、VEGFA、MMP-9和碱性螺旋-环-螺旋转录因子1(twist-related protein 1,TWIST1)等靶蛋白的表达有关。张志恒等[64]发现龙胆苦苷抑制H22肝癌小鼠肿瘤生长及血管生成的作用与提高H22肝癌小鼠免疫力,增加血清干扰素γ(interferon-γ,IFN-γ)、白细胞介素-2(interleukin-2,IL-2)含量及抑制PI3K/AKT信号通路的激活有关,其中,龙胆苦苷可降低瘤组织bFGF、TGF-β、VEGF、p-PI3K及p-AKT表达,提示龙胆苦苷对H22肝癌小鼠的血管生成具有抑制作用,同时,该研究发现龙胆苦苷对H22肝癌小鼠血管生成的抑制作用与抑制PI3K/AKT信号通路的活化有关。SAMERI S等[65]研究发现水飞蓟宾以时间和剂量依赖性方式显著降低CT26细胞存活率,也可通过上调Bax、Caspase-3、自噬相关蛋白5(autophagy-related gene 5,ATG5)、自噬相关蛋白 7(autophagy-related gene 7,ATG7)和BECN1基因的表达并下调Bcl-2来强烈诱导细胞凋亡和自噬,同时,水飞蓟宾显著下调COX-2、HIF-1α、VEGF、血管生成素(angiopoietin,Ang)-2和Ang-4中的mRNA等血管生成基因的表达,除此之外,水飞蓟宾能够抑制CT26细胞的迁移,推测与水飞蓟宾下调MMP-2、MMP-9、CCR-2和CXCR-4的表达有关。见表1。
肿瘤的发病率和病死率高,严重威胁人类生命健康,肿瘤的增殖、浸润与转移与血管生成密切相关,VEGF/VEGFR通路是肿瘤血管生成的重要作用机制之一,目前临床通过抑制VEGF抗血管生成治疗肿瘤取得一定成果,已经有许多抗血管新生单体纳入到对肿瘤的治疗中,靶向VEGF/VEGFR信号途径的几种血管生成抑制剂已被批准用于治疗晚期肺癌,例如,首个被批准用于抑制血管生长的药物贝伐单抗和新型抗血管生成药物阿柏西普可以通过VEGF相竞争的组合来治疗转移性直肠癌,但单纯西药治疗不良反应明显且易耐药,影响临床治疗效果[19]。天然化合物具有来源广泛、资源丰富、疗效好、不良反应小等优势[7-8],越来越多研究发现天然化合物通过抑制VEGF抑制血管生成,对肺癌、结直肠癌、肝癌、乳腺癌、卵巢癌、食管癌等癌症具有良好抗癌活性[24,26,28-29,31,34],对于降低抗肿瘤药物毒性及协同作用方面具有独特优势,当协同其他治疗手段可以产生额外益处,如对放疗、化疗可产生增敏效果及减少耐药性[34,51,54]。但天然化合物具有时间和剂量依赖的局限性,在临床实践中尚没有被作为抗癌的主要治疗剂,因此,亟需明确天然化合物有效成分的潜在分子机制,开展更多减轻天然化合物局限性、增强抗癌活性的研究工作,提升天然化合物在抗癌治疗中的安全性和有效性,为临床开发更加有效、安全、价廉的抗肿瘤血管生成新药。
  • 国家自然科学基金项目(82204981)
  • 河南省特色骨干学科中医学学科建设项目(STG-ZYX06-202145)
  • 河南省中医药科学研究专项(2021JDZX2002; 20-21ZY2115)
  • 河南省中医院博士科研基金项目(2022BSJJ07; 2023BSJJ02)
  • 河南中医药大学研究生科研创新项目(2022KYCX057; 2023KYCX043; 2023KYCX051)
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2025年第43卷第10期
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doi: 10.13193/j.issn.1673-7717.2025.10.029
  • 首发时间:2026-10-30
  • 出版时间:2025-10-10
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基金
国家自然科学基金项目(82204981)
河南省特色骨干学科中医学学科建设项目(STG-ZYX06-202145)
河南省中医药科学研究专项(2021JDZX2002; 20-21ZY2115)
河南省中医院博士科研基金项目(2022BSJJ07; 2023BSJJ02)
河南中医药大学研究生科研创新项目(2022KYCX057; 2023KYCX043; 2023KYCX051)
作者信息
    1.河南中医药大学第二附属医院,河南 郑州 450002
    2.河南中医药大学第二临床医学院,河南 郑州 450046

通讯作者:

张娟(1982-),女,河南安阳人,副教授,硕士研究生导师,博士,研究方向:中医药防治恶性肿瘤的临床及基础研究。E-mail:。
李东东(1989-),男,河南开封人,主治医师,博士,研究方向:中医药防治恶性肿瘤的临床及基础研究。E-mail:。
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https://castjournals.cast.org.cn/joweb/zhzyyxk/CN/10.13193/j.issn.1673-7717.2025.10.029
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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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