Toll样受体4/核因子-κB信号通路参与AVF狭窄的研究进展  

Research progresses in the TLR4/NF-κB signaling pathway involved in AVF stenosis

作　　者：兰智霞 孙秀丽 LAN Zhi-xia;SUN Xiu-li(Department of Clinical Medicine,Baotou Clinical Medical College of Inner Mongolia Medical University,Baotou 014040,China)

机构地区：[1]内蒙古医科大学包头临床医学院临床医学系,包头014040

出　　处：《中国血液净化》2023年第5期373-376,共4页Chinese Journal of Blood Purification

摘　　要：自体动静脉内瘘(arteriovenous fistula,AVF)是血液透析(hemodialysis,HD)患者首选的血管通路,也是终末期肾病(end-stage renal disease,ESRD)患者维持生命的重要渠道。AVF功能障碍增加了ESRD患者住院率及死亡率。目前AVF功能障碍发生机制尚未明确,但其常见原因有血管重塑不足、新生内膜增生(neointimal hyperplasia,NIH)导致的非血栓性血管狭窄。作为Toll样受体(tolllike receptors,TLRs)重要成员的TLR4,在介导血管平滑肌细胞(vascular smooth muscle cells,VSMCs)等细胞的增殖、迁移及细胞外基质(extracellular matrix,ECM)沉积所诱发的NIH致血管狭窄的病理进程中具有关键作用。了解TLR4在AVF狭窄中的确切机制是解决AVF远期通畅问题的当务之急。本文将从AVF狭窄及影响因素、TLR4概述及TLR4/核因子κB(nuclear factor kappa B,NF-κB)信号通路对AVF狭窄的调控作用进行综述。Autologous arteriovenous fistula(AVF)is the preferable vascular access method for hemodi-alysis(HD),being a critical route for end-stage renal disease(ESRD)patients to maintain their lives.AVF dys-function increases the hospitalization rate and mortality of ESRD patients.The mechanism of AVF dysfunc-tion has not been fully elucidated,but insufficient vascular remodeling and neointimal hyperplasia have been considered as the main causes of non-thrombotic vascular stenosis.Toll-like receptor 4(TLR4),an important member in the toll-like receptor family,mediates the proliferation and migration of vascular smooth muscle cells(VSMCs)and deposition of extracellular matrix in AVF wall,leading to intimal hyperplasia and AVF ste-nosis.Comprehension of TLR4 in the development of AVF dysfunction is closely related to the accurate diag-nosis and treatment of AVF dysfunction and maintenance of long-term patency of AVF.Here we summarize the recent progresses in AVF stenosis,its influencing factors,TLR4,and the role of TLR4/NF-κB signal path-way in the pathogenesis of AVF dysfunction.

关 键 词：Toll样受体4/核因子-κB 动静脉内瘘狭窄 炎症 内膜增生 平滑肌细胞 

分 类 号：R318.16[医药卫生—生物医学工程]