Natural Antiplatelet Drugs in Thrombosis Treatment: Prospective Molecular Mechanisms

天然抗血小板化合物應用於血栓的治療：其分子機轉的探討

王榮添(Eng-Thiam Ong) ； 曹心怡(Shin-Yi Tsao) ； 郭志東(Chi-Tong Kuok) ； 張釗監(Chao-Chien Chang)

《輔仁醫學期刊》 16卷1期 (2018/03) Pp. 45-55

https://doi.org/10.3966/181020932018031601006

摘要

Multifaceted hemostatic mechanisms are associated with the pathophysiology of various diseases, including cardiovascular diseases. Among them, dysregulation of platelet activity is related to the progression of atherosclerosis and mainly involves platelet aggregation and decreased blood flow in the vascular endothelium. The major platelet activation pathways mediated by agonists are the arachidonic acid, adenosine diphosphate, serotonin, and nitric oxide pathways. Free radicals also affect the molecules involved in platelet aggregation. These mechanisms have been widely studied and discussed because they are inhibited by plant-based compounds that are used in complementary and alternative medicine for reducing platelet aggregation. Current antiplatelet therapy is highly effective in preventing atherothrombotic complications. Nevertheless, some patients continue to experience recurrent complications despite receiving appropriate treatment because of the pharmacokinetics and interactions of consumed drugs, the genetic backgrounds of the patients, and the increased frequency of thrombus formation. Hence, considerable research has been directed toward providing new antiplatelet drugs that exhibit superior aggregation-preventing potential but do not increase bleeding risk. In this review, we discuss unique natural antiplatelet drugs and their potential inhibition of platelet aggregation.

關鍵字

antiplatelets ； natural products ； antithrombosis ； molecular mechanism

並列摘要

複雜的凝血機制所牽涉的各種病理生理狀態，包括心血管疾病。其中，血小板活性的失調關係到動脈粥樣硬化的進展，主要是血小板凝集和血管內皮細胞內的血流量減少。活化血小板的主要分子途徑包括花生四烯酸途徑、二磷酸腺苷途徑、血清素途徑、一氧化氮途徑及自由基的作用，它們都參與血小板凝集作用。在替代醫學中，利用藥用植物來減少血小板聚集抑制作用，這些機制已經被廣泛的研究和討論。目前的抗血小板治療是非常有效防止動脈粥樣硬化的併發症。然而，有些患者儘管被妥善治療仍會出現復發性併發症，可能跟藥物的相互作用與個人體質有關。因此大量的研究者致力於發展新的抗血小板藥物能具有更好的抗血小板效果且不增加出血風險。在這篇文章中，我們回顧討論多種天然抗血小板化合物，它們獨特的抑制血小板凝集作用，未來在心血管疾病治療上可提供方向。

並列關鍵字

抗血小板 ； 天然化合物 ； 抗血栓 ； 分子機轉