肺动脉高压血管重塑过程中的巨噬细胞核心作用机制研究探讨  

Study on the mechanism of macrophages promoting pulmonary hypertension by affecting pulmonary vascular remodeling

作　　者：陈倩冰 李逸轩 刘怡曼 孙濛濛[3] 杨剑 CHEN Qianbing;LI Yixuan;LIU Yiman;SUN Mengmeng;YANG Jian(State Key Laboratory of Component-based Chinese Medicine,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;Institute of Traditional Chinese Medicine,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;Changchun University of Traditional Chinese Medicine,Changchun 130117,China;Hai-he Laboratory of Modern Chinese Medicine,Tianjin 301617,China)

机构地区：[1]天津中医药大学,省部共建组分中药国家重点实验室,天津301617 [2]天津中医药大学中医药研究院,天津301617 [3]长春中医药大学,长春130117 [4]现代中医药海河实验室,天津301617

出　　处：《天津中医药》2024年第10期1325-1334,共10页Tianjin Journal of Traditional Chinese Medicine

基　　金：国家重点研发计划(2021YFC1712902);组分中药国家重点实验室资助课题(CBCM2020202)。

摘　　要：肺动脉高压(PAH)是一种慢性进行性心肺疾病,患者临床主要有肺血管重塑、肺血管血流阻力连续性升高、右心肥大等表现,最终多因右心衰竭死亡。肺血管重塑是肺血管阻力增加的主要原因之一,在结构上主要表现为外膜增厚纤维化、中膜肥厚、内膜增殖和纤维化等。结合近年来的新型冠状病毒感染患者报告,发现严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的绝大多数死者肺中出现肺血管增厚现象。疾病早期炎症反应通路被激活,其中,以巨噬细胞为代表的免疫细胞被发现,可以共同发挥作用并推动PAH的发生发展。因此,文章着眼于巨噬细胞与肺血管的重塑关系,系统总结近5年相关文献,归纳巨噬细胞免疫调节肺动脉高压的研究进展,阐述肺血管主要构成细胞比例及功能变化,梳理巨噬细胞影响肺血管结构及重塑过程的可能作用机制,旨在为肺动脉高压的临床治疗,特别是在病毒感染造成的肺动脉高压过程中,寻找新的治疗靶点和免疫调节思路。Pulmonary arterial hypertension(PAH) is a chronic progressive heart and lung disease.The main clinical manifestations of patients are pulmonary vascular remodeling,increased pulmonary vascular resistance continuity,right heart hypertrophy,etc.,and eventually died of right heart failure.Pulmonary vascular remodeling is one of the main reasons for the increase of pulmonary vascular resistance.Structurally,it is mainly manifested as thickening and fibrosis of the outer membrane,thickening of the middle membrane,intimal proliferation and fibrosis.Combined with recent reports of novel coronavirus patients,it was found that pulmonary vascular thickening occurred in the lungs of most of the deceased patients with Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2).In the early stage of the disease,the inflammatory response pathway is activated.Among them,immune cells represented by macrophages are found to work together to promote the occurrence and development of PAH.Therefore,this article focuses on the relationship between macrophages and pulmonary vascular remodeling,systematically summarizes the relevant literature in the past five years,summarizes the research progress of macrophage immune regulation of pulmonary hypertension,expounds the changes of the proportion and function of the main components of pulmonary vessels,and sorts out the possible mechanism of macrophages affecting the structure and remodeling process of pulmonary vessels,aiming to find new therapeutic targets and immune regulation ideas for the clinical treatment of pulmonary hypertension,especially in the process of pulmonary hypertension caused by viral infection.

关 键 词：肺动脉高压 巨噬细胞 肺血管重塑 免疫调节 

分 类 号：R543.2[医药卫生—心血管疾病]