内皮细胞与心肌细胞交互对话参与阿霉素心脏毒性的研究进展  

Research progress of the involvement of the cross-talk between endothelial cells and cardiomyocytes in doxorubicin-induced cardiotoxicity

作　　者：瞿礼萍[1] 闵志强[1] 张珵[1] 彭希[1] 刘晓帅[2] 邹文俊[1] QU Li-ping;MIN Zhi-qiang;ZHANG Cheng;PENG Xi;LIU Xiao-shuai;ZOU Wen-jun(School of Pharmacy,Chengdu University of Traditional Chinese Medicine,Chengdu 611137,Sichuan Province,China;Operations Management Oepartment,Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital,Chengdu 610072,Sichuan Province,China)

机构地区：[1]成都中医药大学药学院,四川成都611137 [2]四川省医学科学院·四川省人民医院运营管理部,四川成都610072

出　　处：《中国临床药理学杂志》2025年第3期410-415,共6页The Chinese Journal of Clinical Pharmacology

基　　金：国家自然科学基金资助项目(82274324);四川省自然科学基金杰出青年科学基金资助项目(2024NSFJQ0045)。

摘　　要：阿霉素广泛应用于多种恶性肿瘤的一线治疗方案,但剂量依赖性、不可逆性心脏毒性(DIC)严重限制了其临床应用,是长期困扰临床的难题。本文综合国内外肿瘤心脏病学最新临床指南,总结了DIC的防治现状,并跳出传统侧重阿霉素直接损伤心肌细胞引起DIC的观点,综述了近年关于心脏血管内皮细胞与心肌细胞间交互对话参与DIC的研究进展,提示心脏血管内皮细胞在心脏发育和功能维持中发挥关键作用。阿霉素不仅能先于心肌细胞直接损伤心脏内皮细胞,还可破坏其与心肌细胞间的旁分泌信号和物理屏障,造成细胞间交互对话异常,最终影响心肌细胞存活与功能并导致DIC。Doxorubicin is widely used as a first-line therapeutic option in the treatment of several malignant tumors,but its clinical application is severely limited by the dose-dependent and irreversible cardiotoxicity,which has been a long-standing clinical challenge.We analyze the latest clinical guidelines on oncological cardiology and summarize the current status of doxorubicin-induced cardiotoxicity(DIC)prevention and treatment.On this basis,we have gone beyond the traditional view of direct damage to cardiomyocytes,and reviewed the research progress in recent years on the cross-talk between cardiac vascular endothelial cells and cardiomyocytes involved in DIC.The results suggest that cardiac endothelial cells play a key role in the development and maintenance of cardiac function.Doxorubicin not only directly damages these cells,but also disrupts the paracrine signals and physical barriers between them and cardiomyocytes,ultimately leading to an imbalance in cell communication and affecting cardiomyocyte survival and function,resulting in DIC.

关 键 词：阿霉素心脏毒性 心肌细胞 内皮细胞 旁分泌 物理屏障 

分 类 号：R979.1[医药卫生—药品]