细胞外基质（extracellular matrix，ECM）作为细胞生长、迁移和分化的重要调控因素，在脏器纤维化过程中起着关键作用。ECM硬度或结构改变被认为是一种重要的机械信号，它通过调控细胞的行为及功能推动疾病的进展。肌成纤维细胞表型转化、基质交联以及转化生长因子-β（transforming growth factor-β，TGF-β）均会导致ECM的病理性重塑。中药可以通过直接干预ECM的异常沉积与重塑，或通过调节机械信号转导通路间接抑制细胞对基质硬度的响应，从而有效打破纤维化过程中“基质改变-机械信号激活-细胞表型转化”的恶性循环而发挥抗纤维化作用。中药靶向调控ECM有望打破纤维化进展的力学驱动机制，为抗纤维化治疗提供新视角，并为药物开发开辟新的策略。

The extracellular matrix (ECM), as an important regulatory factor for cell growth, migration and differentiation, plays a crucial role in the process of organ fibrosis. The alteration in ECM stiffness or structure is considered an important mechanical signal that drives disease progression by regulating cellular behavior and function. Myofibroblast phenotype transformation, matrix crosslinking, and transforming growth factor-β (TGF-β) all contribute to pathological remodeling of the ECM. Traditional Chinese medicine (TCM) can directly intervene in abnormal ECM deposition and remodeling or indirectly suppress the cell response to matrix stiffness by regulating mechanical signal transduction pathways, effectively breaking the vicious cycle of “matrix alteration-mechanical signal activation-cell phenotype transformation” in the fibrosis process and exerting an anti-fibrotic effect. Targeted regulation of ECM by TCM holds promise in disrupting the mechanical driving mechanisms of fibrosis progression, offering new perspectives for anti-fibrosis treatment and opening new strategies for drug development.

R285

国家自然科学基金项目（82374332）；中国中医科学院科技创新工程重点协同攻关项目（CI2023C026YL）；中央高水平中医医院临床研究和成果转化能力提升项目（HLCMHPP2023086）；中央高水平中医医院临床研究和成果转化能力提升项目（HLCMHPP2023013）；深圳市医疗卫生三名工程（SZZYSM202311014）