心力衰竭中的炎症反应及胆碱能抗炎通路的研究进展

炎症在心血管疾病发生发展中起着重要的作用。越来越多的研究表明,心力衰竭（HF）是一种炎症性疾病,抗炎将是HF治疗中极有希望的一种治疗措施。心血管疾病与胆碱能神经活性有着密切的关系,近年来研究表明,胆碱能抗炎通路（CAP）能够反馈性监测、调整炎症反应。本文主要从HF和炎症以及CAP在临床治疗HF中的应用前景作一综述。     

胆碱能抗炎通路:缺血性脑卒中炎症反应的可能调节机制

我国每年有150万～200万新发脑卒中的病例,校正年龄后的脑卒中年发病率为(116～219)/10万人口,年死亡率为(58～142)/10万人口,现存脑血管病患者700余万人,其中约有70%为缺血性脑卒中〔1〕。     

胆碱能抗炎通路对急性食管炎大鼠的保护作用

目的:研究胆碱能抗炎通路(CAP)在急性食管炎模型中对大鼠食管组织的细胞因子水平、胆碱乙酰转移酶(ChAT)、一氧化氮合成酶(NOS)的活性以及食管损伤程度的影响,探讨CAP是否对实验性食管炎具有保护作用.方法:通过对大鼠食管下段持续滴注0.1mol/L盐酸.胃蛋白酶溶液诱导制备急性食管炎模型.成年♂SD大鼠40只,随机分为5组:生理盐水组(NS组),盐酸-胃蛋白酶滴注组(AP组),假手术组(SHAM组),迷走神经切断组(VTM组)及迷走神经电刺激组(VNS组).测定食管组织中肿瘤坏死因子-α(TNF-α)、白介素-6(IL-α)、白介素-10(IL-10)的浓度及ChAT、NOS的活性.并对食管的损伤程度进行肉眼及光镜下评分.结果:与NS组相比,在盐酸-胃蛋白酶滴注诱导的大鼠急性食管炎组织中,上述细胞因子的浓度及ChAT、NOS的活性均有所升高.与假手术组相比,通过电刺激迷走神经,可抑制促炎细胞因子TNF-α和IL-6的升高(135.6±11.6vs 200.0±20.5.166.9±44.3 vs 305.6±16.5,均P<0.05),但对抑炎因子IL-10的水平并无影响;并且使食管的炎症程度有所减轻.在双侧颈部迷走神经切除后,大鼠食管的炎症损伤程度加重,TNF-α、IL-6的水平亦明显升高(283.8±33.6 vs 200.0±20.5,P<0.05;515.1±77.1 vs305.6±16.5,P<0.01),食管组织中NOS的活性下降.各滴酸组食管下段的大体和镜下食管炎评分均明显高于NS组CP<0.01).VTM组食管组织大体及光镜评分均较SHAM组有明显升高(P<0.01及0.05).VNS组食管组织的食管炎评分比VTM组显著降低(P<0.01).结论:胆碱能抗炎通路通过传出迷走神经对大鼠实验性食管炎具有一定的保护作用.     

胆碱能抗炎通路对肝脏炎性反应的影响

胆碱能抗炎通路是调节免疫系统的一种神经生理机制,其在脾脏、肝脏和胃肠道等网状内皮系统中通过乙酰胆碱抑制细胞因子的合成,控制炎性反应。肝脏的天然免疫紊乱常导致肝脏炎性细胞的产生增多,引起慢性炎性反应,乙酰胆碱与巨噬细胞和其他分泌细胞因子的细胞表面的α7烟碱型乙酰胆碱受体（α7 nAChR）相互作用,抑制致炎细胞因子的合成和释放,防止组织损伤。此文综述胆碱能抗炎通路调节炎性反应的神经生理机制及其对非酒精性脂肪性肝炎（NASH）的影响。     

葛根素通过激活胆碱能抗炎通路抑制大鼠脑缺血再灌注损伤

目的从胆碱能抗炎通路方面探讨葛根素对大鼠脑缺血再灌注损伤的保护作用机制。方法 130只大鼠随机分为5组:假手术组、模型组、葛根素组、α银环蛇毒素组和尼古丁组。葛根素组、α银环蛇毒素组大鼠尾静脉注射葛根素,尼古丁组尾静脉注射尼古丁,预给药5 d后,应用线栓法建立大鼠右侧大脑中动脉闭塞再灌注模型。缺血再灌注即刻,α银环蛇毒素组尾静脉注射α银环蛇毒素。观察各组动物神经功能损伤评分、海马区脑组织病变,检测缺血侧脑组织炎症因子含量。结果尼古丁和葛根素均能减轻模型大鼠的神经功能损害,改善海马区脑组织炎症细胞浸润,降低促炎因子IL-1β、IL-6和TNF-α含量,升高抗炎因子IL-10含量;α银环蛇毒素可阻断上述抗炎效应;尼古丁与葛根素抗炎效应无显著性差异。结论葛根素对大鼠脑缺血再灌注炎症损伤有保护作用,可能是通过激活胆碱能抗炎通路完成的。     

阿片类药物对冠状动脉旁路移植术患者胆碱能抗炎通路影响的研究现状

<正>冠状动脉缺血所致心肌梗死及低心排出量综合征(低心排)是不停跳冠状动脉旁路移植手术(OPCABG)围术期死亡的主要原因,由多种炎症介质导致的炎症反应是其主要因素之一。现在越来越多的研究证实,手术刺激导致的一系列细胞炎症因子,如TNF、IL-1、IL-6及IL-8等的大量产生,机体发生持续而严重的炎症反应,进而导致全身炎症反应综合征(systemic inflammatory response syndrome,SIRS),它是     

冠心病抗炎治疗通路现状与展望

冠心病被认为是一种炎症性疾病,抗炎治疗成为进一步降低冠心病剩余风险的希望。最近,针对冠心病不同抗炎通路的抗炎治疗又出现了几项大型心血管结局试验,并取得了一些有价值的结论。现就冠心病抗炎治疗通路研究现状及展望做一综述。     

预电针调节胆碱能神经相关蛋白对AD样大鼠学习记忆能力及脑内炎症的影响

目的 观察预电针对AD样大鼠学习记忆能力及脑内炎症的影响.方法 30只SD大鼠分成正常组、模型组、预电针组,每组10只.正常组不做干预,模型组、预电针组每日腹腔注射D半乳糖溶液制备AD样大鼠模型,预电针组另予以针刺百会、足三里穴,接HANS-200A韩式电针仪,连续波,电流1 mA,频率50 Hz,1次/d,20 mi...     

Cholinergic control of inflammation

Cytokine production is necessary to protect against pathogens and promote tissue repair, but excessive cytokine release can lead to systemic inflammation, organ failure and death. Inflammatory responses are finely regulated to effectively guard from noxious stimuli. The central nervous system interacts dynamically with the immune system to modulate inflammation through humoral and neural pathways. The effect of glucocorticoids and other humoral mediators on inflammatory responses has been studied extensively in the past decades. In contrast, neural control of inflammation has only been recently described. We summarize autonomic regulation of local and systemic inflammation through the ‘cholinergic anti‐inflammatory pathway’, a mechanism consisting of the vagus nerve and its major neurotransmitter, acetylcholine, a process dependent on the nicotinic acetylcholine receptor α7 subunit. We recapitulate additional sources of acetylcholine and their contribution to the inflammatory response, as well as acetylcholine regulation by acetylcholinesterase as a means to attenuate inflammation. We discuss potential therapeutic applications to treat diseases characterized by acute or chronic inflammation, including autoimmune diseases, and propose future research directions.     

Vagal activities are involved in antigen-specific immune inflammation in the intestine

Background and Aims: The mechanism of intestinal immune inflammation, such as food allergy, remains to be further understood. The present study aims to investigate the role of the vagal nerve in the pathogenesis of skewed T‐helper 2 (Th2) responses in the intestine. Methods: The expression of the immunoglobulin E (IgE) receptor on the vagus nerve in the mouse intestine was observed by immunohistochemistry. Vagus ganglion neurons (VGN) were isolated from mice and cultured in vitro. The IgE receptor/IgE complex on vagus neurons was examined by immune precipitation assay. A food allergy mouse model was developed; the effect of the partial removal of the vagal nerve (PRVn) via surgery or administration with anticholinergic agents on the suppression of Th2 inflammation was evaluated. Results: The high‐affinity IgE receptor was detected on the intestinal vagus nerve. An increase in the expression of the IgE receptor on the vagus nerve was observed in the intestines of mice with intestinal immune inflammation. Isolated mouse VGN express IgE receptor I, which could form complexes with IgE. Re‐exposure to specific antigens activated the sensitized VGN, manifesting the release of transmitter glutamate that could activate dendritic cells by increasing the expression of CD80 and major compatibility complex class II and suppressing interleukin‐12. The PRVn suppressed Th2 inflammation in the intestine. Conclusions: The intestinal vagus nerve in mice expresses a high‐affinity IgE receptor. An antigen‐specific immune response can activate the vagus nerve in the intestine and induces the release of transmitters to modulate dendritic cell phenotypes that facilitate the development of skewed Th2 polarization in the intestine.     

The effects of electroacupuncture and laser acupuncture therapy for patients with major trauma: A study protocol

Background:Major trauma is the leading cause of death in the young population. The inflammatory and anti-inflammatory responses are associated with posttraumatic morbidity and mortality; however, it is not fully clear how to reestablish the homeostasis in patients with major trauma.Methods:This study will be a prospective, randomized, placebo-controlled, partially double-blinded, three-armed trial. One hundred eighty participants diagnosed with major trauma will be randomly assigned to an electroacupuncture (EA), a laser acupuncture (LA), or a sham laser acupuncture group in a 1:1:1 ratio. All participants will undergo EA, LA, or sham laser acupuncture intervention once a day on 5 acupoints (LI4, PC6, ST36, SP6, and EX-HN1) for 14 consecutive days after enrollment. The primary outcome measure will be the length of hospital stay. Secondary outcomes will be inflammatory mediators, including serum C-reactive protein, interleukin (IL)-6, tumor necrosis factor-α, IL-1β, and IL-10. Clinical outcomes will be numeric rating scale scores for pain, sequential organ failure assessment, ICU length of stay, 30-day mortality, and WHO Disability Assessment Schedule. Data will be analyzed by chi-square test or t test for pairwise comparisons, as well as one-way ANOVA followed by post hoc Tukey method between groups.Objectives:The aim of this protocol is to investigate the clinical effects of EA and LA on major trauma.Trial registration:ClinicalTrials.gov Identifier: {"type":"clinical-trial","attrs":{"text":"NCT04970433","term_id":"NCT04970433"}}NCT04970433. Registered on July 21, 2021.     

儿茶素调控MAPK通路改善幼鼠过敏性气道炎症反应的机制研究

目的探索儿茶素调控丝裂原活化蛋白激酶(MAPK)通路改善幼鼠过敏性气道炎症反应的机制。方法选取SPF级BALB/c纯系小鼠50只,根据随机数字表法分为模型组、正常组、阳性对照组、儿茶素低剂量组及儿茶素高剂量组,每组各10只。除正常组外,其他各组小鼠制备过敏性哮喘模型,成功造模后阳性对照组小鼠灌胃剂量为0.5 mg/kg的地塞米松药液,儿茶素低剂量组及儿茶素高剂量组分别灌胃剂量为1 mg/kg、2 mg/kg儿茶素药液,模型组和正常组灌胃等剂量生理盐水,1次/d。观察小鼠支气管肺泡灌洗液(BALF)内分类细胞、总细胞计数及白细胞介素13(IL-13)、IL-5、IL-4水平,检测小鼠肺组织内p-p38MAPK、ERK、p-ERK、p38MAPK蛋白表达及p38MAPK、ERK mRNA表达。结果与正常组比较,模型组小鼠BALF内IL-13、IL-5、IL-4水平均升高。与模型组比较,阳性对照组、儿茶素低剂量组及儿茶素高剂量组小鼠BALF内IL-13、IL-5、IL-4水平升高降低,差异均有统计学意义(P值均<0.05)。与正常组比较,模型组小鼠肺组织内p-p38MAPK、p-ERK蛋白表达升高。与模型组比较,阳性对照组、儿茶素低剂量组及儿茶素高剂量组小鼠肺组织内p-p38MAPK、p-ERK蛋白表达均降低,差异均有统计学意义(P值均<0.05)。与正常组比较,模型组小鼠肺组织内p38MAPK、ERK mRNA表达均上升,差异均有统计学意义(P值均<0.05)。与模型组比较,阳性对照组、儿茶素低剂量组及儿茶素高剂量组小鼠肺组织内p38MAPK、ERK mRNA表达均降低,差异均有统计学意义(P值均<0.05)。结论儿茶素可使过敏性哮喘小鼠气道内炎症反应有效改善,其作用机制可能和抑制ERK/MAPK信号路径激活有联系。     

Exploitation of the nicotinic anti-inflammatory pathway for the treatment of epithelial inflammatory diseases

INTRODUCTION Tobacco smoke appears to affect susceptibility to and theseverity of various skin and mucosal diseases differently. For example, tobacco smoking is associated with an increased incidence and clinical severity of psoriasis[1-3] and Crohn’s di…     

Sensory neuron regulation of gastrointestinal inflammation and bacterial host defence

Sensory neurons in the gastrointestinal tract have multifaceted roles in maintaining homeostasis, detecting danger and initiating protective responses. The gastrointestinal tract is innervated by three types of sensory neurons: dorsal root ganglia, nodose/jugular ganglia and intrinsic primary afferent neurons. Here, we examine how these distinct sensory neurons and their signal transducers participate in regulating gastrointestinal inflammation and host defence. Sensory neurons are equipped with molecular sensors that enable neuronal detection of diverse environmental signals including thermal and mechanical stimuli, inflammatory mediators and tissue damage. Emerging evidence shows that sensory neurons participate in host–microbe interactions. Sensory neurons are able to detect pathogenic and commensal bacteria through specific metabolites, cell‐wall components, and toxins. Here, we review recent work on the mechanisms of bacterial detection by distinct subtypes of gut‐innervating sensory neurons. Upon activation, sensory neurons communicate to the immune system to modulate tissue inflammation through antidromic signalling and efferent neural circuits. We discuss how this neuro‐immune regulation is orchestrated through transient receptor potential ion channels and sensory neuropeptides including substance P, calcitonin gene‐related peptide, vasoactive intestinal peptide and pituitary adenylate cyclase‐activating polypeptide. Recent studies also highlight a role for sensory neurons in regulating host defence against enteric bacterial pathogens including Salmonella typhimurium, Citrobacter rodentium and enterotoxigenic Escherichia coli. Understanding how sensory neurons respond to gastrointestinal flora and communicate with immune cells to regulate host defence enhances our knowledge of host physiology and may form the basis for new approaches to treat gastrointestinal diseases.