Objective:

To explore the dual roles of macrophage metabolic reprogramming in rheumatoid arthritis and coronary heart disease and evaluate the therapeutic potential of traditional Chinese medicine compounds.

Approach:

• Macrophage Polarization: Examines the metabolic changes in macrophages during rheumatoid arthritis and coronary heart disease, focusing on the shift from oxidative phosphorylation to glycolysis.
• Metabolic Regulators: Identifies key metabolic regulators such as Pim2 kinase and the PI3K/AKT pathway that influence macrophage polarization and inflammation.
• Traditional Chinese Medicine: Evaluates specific compounds from traditional Chinese medicine, including berberine and ginsenoside Rb1, that may rebalance macrophage metabolism and reduce inflammation.

Key Findings:

• Pro-inflammatory M1 macrophages prefer aerobic glycolysis, while anti-inflammatory M2 macrophages rely on oxidative phosphorylation.
• Rheumatoid arthritis and coronary heart disease disrupt the balance towards glycolysis, increasing inflammation and tissue damage.
• Certain traditional Chinese medicine compounds, such as berberine and ginsenoside Rb1, can potentially shift macrophage metabolism away from inflammatory dominance.

Interpretation:

Macrophage metabolic reprogramming plays a role in the inflammatory processes of rheumatoid arthritis and coronary heart disease.

Limitations:

• The review primarily focuses on metabolic pathways without extensive clinical trial data on the efficacy of traditional Chinese medicine.
• Further research is needed to understand the interactions between macrophage metabolism and disease pathology.

Conclusion:

Macrophage polarization and metabolism are critical in the pathogenesis of rheumatoid arthritis and coronary heart disease.