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作 者:周煜辰 王恒 卢洋 徐涛[2] 陈晓庆[1] Zhou Yuchen;Wang Heng;Lu Yang;Xu Tao;Chen Xiaoqing(Department of Spine Surgery,Affiliated Hospital of Nantong University,Nantong 226001,China;Nantong University,School of Medicine,Nantong 226001,China)
机构地区:[1]南通大学附属医院脊柱外科,南通226001 [2]南通大学医学院,南通226001
出 处:《中华创伤杂志》2024年第6期569-576,共8页Chinese Journal of Trauma
摘 要:脊髓损伤是一种严重致残性疾病,其病理生理过程主要包括原发性损伤和继发性损伤,原发性损伤主要由瞬时机械损伤引起,继发性损伤主要由长期的炎症级联反应导致。在原发性机械损伤和继发性炎症损伤对髓鞘的破坏下,损伤局部存在大量富含胆固醇的髓鞘碎片,这些髓鞘碎片主要被骨髓来源的巨噬细胞(BMDMs)吞噬。由于BMDMs自身胆固醇的处理能力有限及外排功能不足,其胞内会形成大量由中性脂肪构成的脂质小滴,使得BMDMs表现出"泡沫样"形态,发展为泡沫细胞。泡沫细胞进一步加重损伤局部炎症,使得炎症迁延,并促进局部瘢痕的形成,从而阻碍神经再生及感觉、运动功能恢复。目前,对脊髓损伤中泡沫细胞的形成、作用机制及干预措施尚无较完整的总结。为此,笔者就泡沫细胞对脊髓损伤病理进程影响及其调控的研究进展进行综述,为脊髓损伤的相关基础研究及临床治疗提供新的思路。Spinal cord injury is a serious disabling disease and its pathological and physiological processes mainly consist of primary and secondary injury.Primary injury is mainly caused by instantaneous mechanical injury while secondary injury is chiefly triggered by long-term inflammatory cascade reactions.With myelin sheath damaged in primary mechanical injury and secondary inflammatory injury,there was a large amount of cholesterol-rich myelin debris in the damaged area,which is mainly swallowed by bone marrow-derived macrophages(BMDMs).Owing to the limited capacity for processing cholesterol and insufficient efflux pump function of BMDMs,a large number of intracellular lipid droplets composed of neutral fat will be formed,as a result of which BMDMs show a"foamlike"shape and develop into foam cells.Foam cells further aggravate the local inflammation of the injury,prolong the inflammation and promote the formation of local scars,thus hindering nerve regeneration and recovery of sensory and motor functions.Currently,there has been no comparatively complete summary concerning the formation,mechanism of action,intervention of foam cells in spinal cord injury.To this end,the authors reviewed the research progress on the influence and regulation of foam cells on the pathological process of spinal cord injury,hoping to provide new ideas for the related basic research and clinical treatment of spinal cord injury.
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