[Research advance on regulation of SREBP pathway by TCM in prevention and treatment of hyperlipidemia]

Hyperlipidemia(HLP) is a significant independent risk factor for the occurrence and development of cardiovascular and cerebrovascular diseases. Currently, the common clinical lipid-lowering agents include statins(inhibiting HMG-CoA reductase), fibrates(activating PPARα), cholesterol absorption inhibitors(blocking NPC1L1), and PCSK9 inhibitors(preventing LDLR degradation). However, clinical concerns remain about the combination use of multiple drugs, hepatorenal toxicity, and poor adherence to long-term application. The sterol regulatory element-binding protein(SREBP) pathway serves as a master regulator of lipid synthesis, concurrently controlling multiple steps in this process. Targeted intervention of the overactivated SREBP pathway has emerged as a novel research direction for regulating lipid metabolism disturbances, though it remains largely in the preclinical stage of drug research and development. TCM demonstrates multi-target and holistic regulatory advantages in regulating the SREBP pathway. Studies reveal that TCM compounds(Zexie Decoction, Xiangsha Liujunzi Decoction, and so on) and active constituents(berberine, curcumin, and so on) can systematically ameliorate lipid metabolic disturbances by inhibiting SREBP-1c/2 activation and the expression of downstream genes such as FAS, ACC, and HMGCR. This review summarized clinical trials and experimental research in recent years on the mechanisms by which TCM prevents and treats HLP by regulating the SREBP pathway, aiming to provide theoretical basis and new insights for the prevention and treatment of HLP as well as further research.