Correlation Between the Mechanism of

doi:10.1009-0959.2026.010002

Abstract

Abstract:

Objective： This study systematically elucidates the role of "Lipophagy Imbalance" in the pathological progression of atherosclerosis （AS） from the perspective of the traditional Chinese medicine （TCM） theory of "Turbid Pathogen Impairing Clarity". It aims to reveal the biological correlation between TCM’s concept of "turbid pathogen" and modern lipid metabolism， thereby providing theoretical support for the collaborative prevention and treatment of AS through integrated traditional Chinese and western medicine.Methods： By analyzing studies on the molecular mechanisms of "Lipophagy Imbalance" and the connotation and extension of the "Turbid Pathogen Impairing Clarity" theory， and by integrating the TCM pathogenesis characteristics of AS， this study elucidates the interaction between "Lipophagy Imbalance" and "Turbid Pathogen Impairing Clarity" in the development and progression of AS.Results： Lipophagy， as a key form of cellular autophagy， maintains lipid homeostasis by degrading lipid droplets through lysosomes. However， "Lipophagy Imbalance" leads to dysfunction in lipid metabolism， directly promoting the formation of foam cells and the progression of plaques.The accumulation of pathological products in the body， such as phlegm， dampness， and lipid turbidity， which are considered "turbid pathogens"， obstructs the flow of qi， leading to the failure of "clear yang to ascend"， a manifestation of "Turbid Pathogen Impairing Clarity". This disruption of qi-blood circulation manifests in vessels as vessel impediment， a mechanism closely linked to lipid metabolism dysregulation in atherosclerosis.The two concepts present multiple associations in AS： modern medicine considers "Lipophagy Imbalance" as a key material basis for the onset of AS， while traditional Chinese medicine often considers "phlegm turbidity"， or "turbid pathogens"， as one of the core pathological factors of AS. The microscopic mechanism of lipid droplet accumulation caused by "Lipophagy Imbalance" highly aligns with the macroscopic pathology of "vessel occlusion". The pathological outcome of ischemic events triggered by plaque rupture corresponds to the clinical manifestations of "Impairing Clarity". Traditional Chinese medicine can modulate the state of "Lipophagy Imbalance" to block the pathological process of turbid pathogen obstructing the vessels.Conclusion： The "Turbid Pathogen Impairing Clarity" theory provides a new interpretive perspective on the pathogenesis of AS. Lipophagy， as a modern medical target， can serve as one of the scientific connotations supporting the treatment of atherosclerosis in TCM.

Key words: , Vessel impediment； , Atherosclerosis； , Turbid pathogen impairing clarity； , Lipophagy imbalance

CLC Number:

R543.5
R259

XU Yongqi, ZHAO Hongxia, YANG Zhen, TAO Xuguang, CHEN Xiangyun, CHU Ce, YUAN Yulu, ZHANG Yuxin, LIU Juanhong, CHEN Wanping, GONG Wenting, WANG Wenlai. Correlation Between the Mechanism of "Lipophagy Imbalance" in Atherosclerosis and the "Turbid Pathogen Impairing Clarity" Theory[J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2025, 27(12): 1263-1263-1268.

References

［1］ Libby P， Buring JE， Badimon L， et al. Atherosclerosis［J］.Nat Rev Dis Primers， 2019，5（1）：56.

［2］ Zhang S， Peng X， Yang S， et al. The regulation， function， and role of lipophagy， a form of selective autophagy， in metabolic disorders［J］.Cell Death Dis， 2022，13（2）：132.

［3］葛均波.内科学［M］.第10版.北京：人民卫生出版社，2024：227-231.

［4］ Alfarisi H， Mohamed ZB， Ibrahim M. Basic pathogenic mechanisms of atherosclerosis［J］.Egypt J Basic Appl Sci， 2020，7（1）：116-125.

［5］ Mizushima N， Komatsu M. Autophagy：renovation of cells and tissues［J］.Cell， 2011，147（4）：728-741.

［6］ Zhang M， Zhang X， Mao L. Mitochondrial autophagy inhibits nucleotide-binding oligomerization domain-like receptor protein 3-mediated pyroptosis and alleviates endothelial cell injury in pregnancy-induced hypertension［J］.Cytojournal， 2025，22：60.

［7］ Han P， Wang H， Chen Y， et al. The role of lipophagy in liver cancer：mechanisms and targeted therapeutic interventions［J］.Front Cell Dev Biol， 2025，13：1562542.

［8］ Shang H， Dai X， Chen J， et al. LAPTM4B as a key regulator in the copper-induced endoplasmic reticulum-lysosome interplay disorder in duck liver and the protective role of baicalin［J］.J Anim Sci Biotechnol， 2025，16（1）：121.

［9］ Montes ID， Amirthagunanathan S， Ganji R， et al. The p97 ATPase and its adaptor UBXD8 maintain peroxisome pools by preventing pexophagy［J］.J Cell Biol， 2025，224（9）：e202409024.

［10］吴璟玥，包晓丹，乔璐，等.mTOR信号通路在脂噬相关疾病中的作用与调控机制［J］.中国实验诊断学，2025，29（3）：349-356.

［11］ Singh R， Kaushik S， Wang Y， et al. Autophagy regulates lipid metabolism.［J］.Nature， 2009，458（7242）：1131-1135.

［12］ Napolitano G， Ballabio A. TFEB at a glance［J］.J Cell Sci， 2016， 129（13）：2475-2481.

［13］ Saikia R， Joseph J. AMPK：a key regulator of energy stress and calcium-induced autophagy［J］.J Mol Med（Berl）， 2021，99（11）：1539-1551.

［14］ Ouimet M， Franklin V， Mak E， et al. Autophagy regulates cholesterol efflux from macrophage foam cells via lysosomal acid lipase［J］.Cell Metab， 2011，13（6）：655-667.

［15］ Liao X， Sluimer JC， Wang Y， et al. Macrophage autophagy plays a protective role in advanced atherosclerosis［J］.Cell Metab， 2012，15（4）：545-553.

［16］ Xiao J， Deng YM， Liu XR， et al. PCSK9： A new participant in lipophagy in regulating atherosclerosis？［J］.Clin Chim Acta， 2019，495：358-364.

［17］郭永胜，黄书婷，渠景连，等.叶天士“浊邪害清”理论探蕴［J］.中华中医药杂志，2022，37（9）：5288-5291.

［18］李德秀，张晓囡，张静怡，等.刘龙涛教授基于“浊邪害清”理论治疗高脂血症的经验［J］.中国医药导报，2024，21（31）：140-143.

［19］张萌，刘子旺.基于“浊邪害清”探析双心疾病的辨治［J］.中医学报，2025，40（6）：1193-1198.

［20］冯慧，凌云，周春祥，等.从代谢重编程角度探讨糖尿病认知障碍浊邪害清病机［J］.南京中医药大学学报，2024，40（8）：759-764.

［21］李娜娜，张芮铭，沙中玮，等.基于“浊邪害清”理论探讨轻度认知障碍的病机与辨治［J］.中医杂志，2023，64（4）：346-349.

［22］易泳鑫，陈茜，高毅东，等.“浊邪害清”理论在急性脑卒中的运用研究［J］.湖北中医杂志，2020，42（7）：30-31.

［23］李英，龚宝莹，朱建华，等.国医大师朱良春从痰瘀论治颈动脉不稳定斑块的学术经验［J］.中国实验方剂学杂志，2021，27（23）：195-200.

［24］周婉宁，杨珺涵，齐雪杉，等.从毛脉失和角度探讨动脉粥样硬化“膏脂-痰浊-痰结-痰瘀”证候演变特征［J］.中医药信息，2025，42（3）：42-47，55.

［25］ Schrijvers DM， De Meyer GR， Martinet W. Autophagy in atherosclerosis：a potential drug target for plaque stabilization［J］.Arterioscler Thromb Vasc Biol， 2011，31（12）：2787-2791.

［26］ Du X， Di Malta C， Fang Z， et al. Nuciferine protects against high-fat diet-induced hepatic steatosis and insulin resistance via activating TFEB-mediated autophagy-lysosomal pathway［J］.Acta Pharm Sin B， 2022，12（6）：2869-2886.

［27］胡戈，秦菲，曹建民，等.姜黄素复合有氧运动对非酒精性脂肪肝大鼠肝功能的改善作用［J］.食品科学，2025，46（10）：178-187.

［28］张艳，杨依林，袁家奇，等.槲皮素通过上调脂解和脂噬途径改善肝细胞脂质蓄积［J］.陆军军医大学学报，2024，46（20）：2301-2312.

［29］ Deng Z， Ren C， Tang C， et al. Syringin alleviates hepatic fibrosis by enhancing autophagic flux and attenuating ER stress-TRIB3/SMAD3 in diabetic mice［J］.Tissue Cell， 2023，83：102159.

［30］ Li Z， Ma J， Kuang Z， et al. β-asarone attenuates Aβ-induced neuronal damage in PC12 cells overexpressing APPswe by restoring autophagic flux［J］.Front Pharmacol， 2021，12：701635.

［31］楼彩霞，王弋，代路路，等.3种中药成分对氧化型低密度脂蛋白诱导人主动脉内皮细胞损伤的影响［J］.中国药业，2024，33（4）：39-42.

［32］余刘勤，贾爱梅，宋永砚.柴胡皂苷抗炎、抗氧化和降脂研究进展［J］.中国动脉硬化杂志，2020，28（1）：87-92.

［33］王梦瑶，李二稳，高改，等.泽泻汤调控Akt/TFEB促进肝细胞脂噬机制研究［J］.中国中药杂志，2022，47（22）：6183-6190.

［34］尹硕，毛舒婷，王莉，等.慈菇消脂丸含药血清对L-02细胞脂肪变模型自噬的干预研究［J］.时珍国医国药，2022，33（5）：1036-1039.

［35］饶春梅，成细华，任婷，等.加味丹参饮含药血清对缺氧/复氧H9C2心肌细胞自噬相关蛋白LC3-Ⅱ及Beclin-1表达的影响［J］.中医杂志，2017，58（12）：1043-1048.

［36］于红红，俞琦，许滔，等.黄连解毒汤含药血清对ox-LDL诱导的RAW264.7源性泡沫细胞模型自噬及炎症反应的影响［J］.中华中医药杂志，2021，36（7）：3828-3832.

［37］倪小鸥，宫丽鸿，张湜，等.搜风祛痰中药对ApoE基因敲除小鼠动脉粥样硬化不稳定斑块自噬相关蛋白Beclin-1和LC3的影响［J］.中西医结合心脑血管病杂志，2016，14（5）：488-491.

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Correlation Between the Mechanism of "Lipophagy Imbalance" in Atherosclerosis and the "Turbid Pathogen Impairing Clarity" Theory

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