代谢重编程在肺动脉高压发病机制中的研究进展  

Advances in metabolic reprogramming in pathogenesis of pulmonary hypertension

作　　者：齐先梅 罗娅 王婧[1] QI Xian-mei;LUO Ya;WANG Jing(Institute of Basic Medical Sciences,Chinese Academy of Medical Sciences,School of Basic Medicine,Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院基础医学研究所,北京协和医学院基础学院,北京100730

出　　处：《中国病理生理杂志》2021年第11期2062-2071,共10页Chinese Journal of Pathophysiology

基　　金：中国医学科学院医学与健康科技创新工程项目(No.2018-I2M-1-001)。

摘　　要：肺动脉高压(pulmonary hypertension,PH)是一组严重的进行性心肺疾病,肺血管收缩、肺中小动脉重构及原位血栓形成引起肺血管阻力逐渐增加,最终导致右心衰竭甚至死亡[1-2]。目前认为促进PH发生发展的关键机制是血管细胞的过度增殖和/或抗凋亡[3],同时血管收缩、炎症及纤维化也参与其中[4-5]。PH患病人数庞大,发病率逐年升高[6],由于对PH发生的病理生理机制认识不全,目前尚无治愈方法[7]。代谢重编程通过供给能量、生物合成中间物和还原性物质,维持细胞的氧化还原稳态并保证生物分子合成,使细胞呈现增殖、迁移以及抗凋亡的肿瘤样恶性表型,导致肺血管重构和右心室肥厚,加速PH的发生发展[7]。Pulmonary hypertension(PH)is a severe pulmonary vascular disease characterized by progressive elevation of pulmonary vascular resistance caused by a variety of factors.The development of PH results in right heart failure and even death.At present,the pathogenic mechanism of PH is not completely clear,and there is still a lack of ef-fective therapeutic drugs in clinic.Previous studies have shown that metabolic reprogramming is one of the important pathophysiological features of PH.Typical metabolic abnormalities include Warburg effects,increased NADPH produc-tion and fatty acid oxidation.Metabolic reprogramming leads to proliferation and anti-apoptosis of pulmonary vascular cells,which then promotes the progress of PH.Hence,regulating metabolic reprogramming in PH may have the potential to alleviate disease progression.This review summarizes the mechanism of metabolic reprogramming in the occurrence and development of PH,combined with current progress of disease diagnosis and treatment,including clinical experimental drugs for metabolic pathways,to provide reference for PH intervention and treatment.

关 键 词：肺动脉高压 代谢重编程 发病机制 

分 类 号：R364.1[医药卫生—病理学] R543.2[医药卫生—基础医学]