# Therapeutic potential of traditional Chinese medicine in pancreatic fibrosis: mechanisms of TCM formulas and active ingredients

## TL;DR

This paper explores how traditional Chinese medicine may help treat pancreatic fibrosis by targeting key biological pathways and cells involved in the disease.

## Contribution

The paper provides a comprehensive analysis of TCM mechanisms in combating pancreatic fibrosis, offering novel therapeutic insights.

## Key findings

- TCM inhibits pancreatic stellate cell activation, a key driver of fibrosis.
- It regulates extracellular matrix breakdown and suppresses macrophage infiltration.
- TCM also inhibits acinar cell apoptosis and targets pathways like TGF-β/Smad and NF-κB.

## Abstract

Pancreatic fibrosis (PF), the primary pathological hallmark of chronic pancreatitis (CP), is recognized as a pivotal driver of CP progression. Currently, no therapies are approved by the U.S. Food and Drug Administration (FDA) specifically for PF treatment, highlighting an urgent need for novel therapeutic strategies. Emerging evidence positions Traditional Chinese Medicine (TCM) as a promising multi-target approach against PF. This paper summarizes the pathogenesis of PF and provides a detailed review and comprehensive analysis of the mechanisms underlying Chinese herbal formulas and active ingredients investigated for PF prevention and treatment in existing experimental studies. Numerous studies indicate that TCM combats PF by inhibiting pancreatic stellate cells (PSCs) activation, regulating extracellular matrix (ECM) breakdown, suppressing macrophage infiltration and polarization, and inhibiting pancreatic acinar cell apoptosis. Current basic research predominantly focuses on PSC activation and associated signaling pathways, particularly key pathways such as TGF-β/Smad, MAPK, NF-κB, and Hedgehog. This work thus offers novel insights and approaches for PF treatment and further research.

lllustration showing the effects of traditional Chinese medicine on pancreatic fibrosis. lt includes Chinese herbal medicine linked to reductions in pancreatic stellate cells activation, macrophage inflammation, acinar cell apoptosis, and extracellular matrix degradation. These are associated with pathways including TGF-β, NF-KB, MAPK .The image illustrates the process aimed at mitigating pancreatic fibrosis.