肾上腺髓质素与支气管肺发育不良  

Adrenomedullin and bronchopulmonary dysplasia

作　　者：张敏(综述) 蔡成(审校)[1] Zhang Min;Cai Cheng(Department of Neonatology,Shanghai Children's Hospital,Shanghai Jiao Tong University,Shanghai 200062,China)

机构地区：[1]上海交通大学附属儿童医院,上海市儿童医院新生儿科,200062

出　　处：《国际儿科学杂志》2019年第8期545-549,共5页International Journal of Pediatrics

基　　金：国家自然科学基金面上项目(81571467).

摘　　要：支气管肺发育不良(bronchopulmonary dysplasia,BPD)是早产儿常见的呼吸系统疾病,以肺泡和肺血管发育不良为特征,目前尚缺乏有效的预防及治疗措施。肾上腺髓质素(adrenomedullin,ADM)是由体循环和肺循环的内皮细胞和平滑肌细胞产生的血管舒张肽,可促进肺泡的生长发育和肺血管的生成。ADM通过三条信号通路在呼吸系统发挥保护作用:(1)通过细胞外信号调节蛋白激酶通路促进肺血管内皮细胞的增殖;(2)通过蛋白激酶B通路减轻肺细胞凋亡改善细胞增殖;(3)下调肺组织烟酰胺腺嘌呤二核苷酸磷酸(nicotinamide adenine dinucleotide phosphate,NADPH)氧化酶4,简称NADPH氧化酶4(NADPH oxidase 4,NOX4)的表达抑制氧化应激反应改善BPD。因此,ADM信号轴可能是治疗BPD的潜在靶点,为临床防治早产儿BPD提供理论依据。Bronchopulmonary dysplasia(BPD)is a common respiratory disease in premature infants characterized by alveolar and pulmonary vascular dysplasia.There are currently no effective preventive and therapeutic measures.Adrenomedullin(ADM)is a vasodilator peptide produced by endothelial and smooth muscle cells of the systemic and pulmonary circulation, which promotes alveolar growth and pulmonary angiogenesis.ADM protects the respiratory system through three signaling pathways:(1)it promotes pulmonary vascular endothelial cell proliferation through extracellular regulated protein kinases(ERK);(2)attenuates lung cell apoptosis and improves cell proliferation through protein kinase B(PKB)pathway;(3)it down-regulates NADPH oxidase 4(NOX4)expression in lung tissue to inhibit oxidative stress and improves BPD.So ADM signaling axis may be a potential therapeutic target for human infants with BPD.It provides theoretical basis for clinical prevention and treatment of BPD in premature infants.

关 键 词：支气管肺发育不良 肾上腺髓质素 细胞外信号调节蛋白激酶 蛋白激酶B 烟酰胺腺嘌呤二核苷酸磷酸氧化酶4 

分 类 号：R722.6[医药卫生—儿科]