Macrophage lipophagy in atherosclerosis: from molecular mechanisms to traditional Chinese medicine interventions

Macrophage lipophagy, the selective autophagic degradation of intracellular lipid droplets, plays a central role in maintaining lipid homeostasis and has emerged as a promising therapeutic target for atherosclerosis (AS). This review systematically synthesizes the classification, molecular mechanisms, and key signaling networks of macrophage lipophagy. Moreover, recent evidence on the anti-AS effects of Traditional Chinese Medicine (TCM) mediated by the regulation of macrophage lipophagy has also been summarized and evaluated, including active metabolites, medicinal plants, herbal formulas and commercial Chinese polyherbal preparations. Despite robust preclinical evidence, challenges remain. Significant efforts are still required to facilitate clinical translation and offer novel comprehensive strategies for the prevention and management of AS.