Regulatory Mechanisms of Inflammatory Signaling Pathways in Atherosclerosis by Traditional Chinese Medicine

Abstract

Atherosclerosis is the main pathological basis of cardiovascular disease. According to the Report on Cardiovascular Health and Diseases in China 2023, there are about 290 million patients in China, and related deaths account for more than 40% of total mortality. Inflammation plays a central role in the onset and progression of atherosclerosis by impairing endothelial function, promoting foam cell formation, and destabilizing plaques, thus forming a persistent “inflammation–injury” cycle. Current Western medical treatments, such as lipid-lowering drugs, antiplatelet therapy, and vascular interventions, remain limited by adverse drug reactions and restenosis. Guided by the holistic perspective and pattern-based treatment of Traditional Chinese Medicine (TCM), therapeutic strategies emphasize the regulation of yin–yang balance and pathological factors such as phlegm, stasis, and toxins, showing multi-component and multi-target advantages. Recent studies have demonstrated that single compounds, herb pairs, and formulae can modulate inflammatory pathways including NF-κB, TLRs, MAPK, and JAK/STAT, thereby suppressing pro-inflammatory cytokines, improving endothelial function, regulating lipid metabolism, and slowing plaque progression. This article reviews research advances over the past five years on TCM interventions in atherosclerosis, aiming to provide theoretical support for mechanistic studies and clinical applications.