[Research progress on mechanisms and therapeutic potential of active components of TCM in intervening lipid metabolism reprogramming in colorectal cancer].

Lipid metabolism reprogramming is a hallmark metabolic feature in the pathogenesis and progression of colorectal cancer(CRC), primarily involved in the aberrant activation of de novo lipogenesis(DNL), disruption of cholesterol homeostasis, enhancement of fatty acid oxidation(FAO), and resistance to ferroptosis. All of these pathological processes mediate malignant progression and multidrug resistance of tumors. According to TCM, the pathological foundation of CRC lies in the interlocking of "dampness, heat, stasis, and deficiency", which exhibits an intrinsic biological consistency with ectopic lipid accumulation, metabolic pathway perturbations, and the imbalance of microenvironmental homeostasis. This article systematically reviewed the molecular regulatory networks of lipid metabolism reprogramming in CRC, emphasizing the molecular mechanisms by which active components of TCM intervene in lipid metabolism homeostasis by modulating core targets such as sterol regulatory element-binding proteins(SREBPs), glutathione peroxidase 4(GPX4), solute carrier family 7 member 11(SLC7A11), and carnitine palmitoyltransferase 1(CPT1). Pharmacological studies demonstrate that active ingredients, including berberine, tanshinone Ⅱ_A, ginsenosides, curcumin, and hesperetin, elucidate the molecular scientific connotations of therapeutic principles, such as "clearing heat, drying dampness, promoting blood circulation, removing toxic substances, strengthening body resistance to consolidate the constitution, and disinhibiting dampness to transform phlegm", by intervening in lipid synthesis, ferroptosis, energy metabolism, and inflammatory signaling pathways. Furthermore, the clinical application potential of active components of TCM in reversing chemotherapy resistance, synergizing with immunotherapy, and the chemoprevention of adenomas is systematically evaluated. By providing an in-depth analysis of the biological correlations between TCM syndrome theory and lipid metabolism regulation, this review aims to offer a pharmacological basis for the development of TCM candidates targeting metabolic remodeling and for the optimization of diagnostic and therapeutic protocols of integrated Chinese and western medicine.