Traditional Chinese Medicine Intervenes in Endoplasmic Reticulum Stress to Treat Diabetic Microvascular Complications：A Review
10.13422/j.cnki.syfjx.20260691
- VernacularTitle:中医药干预内质网应激治疗糖尿病微血管并发症的研究进展
- Author:
Zhenlong ZHOU
1
;
Yu DUAN
2
;
Yutian PANG
3
;
Ying JIA
1
;
Mingwei LI
1
;
Hongyu SHA
4
;
Haichun ZHOU
1
Author Information
1. The Second Clinical Medical College，Heilongjiang University of Chinese Medicine，Harbin 150036，China
2. Shandong University of Traditional Chinese Medicine，Jinan 250300，China
3. Fudan University Shanghai Cancer Center，Shanghai 200030，China
4. Shanghai Haijiang Geriatric Hospital，Shanghai 200080，China
- Publication Type:Journal Article
- Keywords:
diabetic microvascular complications;
endoplasmic reticulum stress （ERS）;
apoptosis;
autophagy;
traditional Chinese medicine
- From:
Chinese Journal of Experimental Traditional Medical Formulae
2026;32(20):293-305
- CountryChina
- Language:Chinese
-
Abstract:
Diabetic microvascular complications （DMC） are major chronic complications of diabetes，primarily including diabetic kidney disease （DKD），diabetic retinopathy （DR），diabetic cardiomyopathy （DCM），and diabetic peripheral neuropathy （DPN）. These complications significantly impact patients' quality of life and prognosis. Modern medicine primarily focuses on symptomatic control in the treatment of DMC，with limited ability to reverse the disease progression. Endoplasmic reticulum stress （ERS），as a central event under hyperglycemic toxicity，is not only a key cause of pancreatic β-cell dysfunction （reduced insulin synthesis and secretion） but also a core driver of damage in various target organs of DMC. It activates three signaling pathways of the unfolded protein response （UPR）-inositol-requiring enzyme 1 （IRE1），activating transcription factor 6 （ATF6），and protein kinase R-like endoplasmic reticulum kinase （PERK），intertwining processes such as autophagy，apoptosis，oxidative stress，and calcium homeostasis imbalance. Traditional Chinese medicine （TCM） offers multi-target and multi-pathway therapeutic advantages and can curb the pathological progression of DMC by regulating ERS. This article systematically reviews the relationships of ERS with pancreatic β-cell function，insulin synthesis，and insulin secretion，and elucidates the core signaling pathways through which ERS mediates DMC. Furthermore，it categorizes and summarizes experimental evidence and mechanisms of single medicinal herbs and their extracts，TCM compound formulas，and modern TCM preparations in regulating ERS for the treatment of various DMC subtypes. Finally，this article proposes ERS as a molecular bridge for integrating traditional Chinese and Western medicine in DMC treatment. Future research should leverage emerging technologies such as network pharmacology，multi-omics analysis，and nano-formulations to establish a synergistic network combining modern hypoglycemic drugs and TCM regulation of ERS. This approach is expected to achieve dual efficacy，enhance drug targeting and bioavailability，deepen the understanding of scientific connotation of TCM，and pave new avenues for the prevention and treatment of DMC.
