Research Progress on Traditional Chinese Medicine Regulating the Keap1/Nrf2/ARE Signaling Pathway to Intervene in Pulmonary Fibrosis

Pulmonary fibrosis(PF) is a chronic progressive respiratory disease, the incidence of which increases with age. Oxidative stress damage is an important pathogenesis of PF and plays a significant role in its development. The Kelch-like ECH-associated protein 1(Keap1)/nuclear factor erythroid 2-related factor 2(Nrf2)/antioxidant response element(ARE) signaling pathway is one of the key intracellular antioxidant stress pathways. It regulates the expression of various antioxidant and detoxifying enzymes, playing a crucial role in maintaining cellular redox balance and metabolism. Studies have shown that active components, extracts, compound prescriptions and proprietary Chinese medicine(TCM) can exert anti-PF effects by inhibiting oxidative stress damage and reducing inflammatory responses, with mechanisms related to the activation of the Keap1/Nrf2/ARE signaling pathway. Based on this, this article reviews the mechanisms of TCM regulation of the Keap1/Nrf2/ARE signaling pathway in the treatment of PF, providing references for the development of new TCM drugs for the treatment of PF.