炎症消散的缺失诱发As斑块形成的作用机制及中药复方干预As炎症新思路的探索

动脉粥样硬化（As）是心脑血管疾病发病和死亡的主要病理基础之一。抗炎是防治As的一条有效途径,一些新型的抗炎药物已经进入了临床研究阶段。近年来的研究发现,炎症消散的缺失也是As斑块形成和破裂的重要因素。本文基于抗炎治疗在As防治中的研究进展,从炎症消散的角度出发,系统总结了炎症消散各方面的缺失对As斑块形成的影响。并深入探讨了胞葬作用在As早期和As斑块成熟期的变化及其所呈现出不同结果的原因。此外,本文结合As炎症消散缺失的作用机制,思考并探讨中医药干预As炎症消散可能的作用靶点,为寻求针对抗炎和促炎症消散双方面调节的抗As药物提供科学依据和理论参考。     

巨噬细胞极化在痛风炎症机制中的研究

痛风性关节炎是一种可涉及一系列复杂的炎症级联扩增反应的自身炎症性疾病, 其区别于其他自身炎性关节病的特征之一是其关节炎症在临床上可表现为自发缓解。促炎因子与抗炎因子动态平衡在痛风炎症自发缓解机制中发挥重要作用。巨噬细胞是人体固有免疫细胞, 在不同的微环境下, 巨噬细胞可极化为促炎的M1型与抗炎的M2型, 不同表型之间的转化贯穿于痛风炎症发生、发展和转归过程。促进巨噬细胞M2型极化可以缓解痛风急性炎症, 故早期调控痛风炎症中M1及M2各亚群之间的平衡成为探索痛风急性炎症新治疗策略的重要切入点。     

高密度脂蛋白蛋白成分修饰对其抗动脉粥样硬化功能的影响

高密度脂蛋白（HDL）通过胆固醇逆向转运、抗氧化、抗炎、抗血栓形成、保护血管内皮细胞等功能发挥其抗动脉粥样硬化（As）作用。近年来研究发现HDL含量与其功能不成比例,在As、代谢综合征、慢性炎症、免疫系统疾病患者体内,HDL组分改变如蛋白成分氧化、糖基化等修饰可降低其抗As功能,甚至表现出促炎、促氧化等特性,成为As发生发展的危险因素。     

动脉粥样硬化的炎症应答特征及运用

动脉粥样硬化是多种心血管疾病的共同病理基础。越来越多证据表明,炎症在动脉粥样硬化的病理生理过程中发挥重要作用。动脉粥样硬化的发展受先天性免疫与适应性免疫细胞成分调控,且与全身炎症水平相关,多种炎症因子可作为动脉粥样硬化相关心血管疾病的预测指标。同时,一些抗炎治疗的临床试验表明,降低系统性炎症因子水平能够减少心血管事件风险。文章重点阐述了炎症在动脉粥样硬化中的作用、动脉粥样硬化发展中免疫应答的特征,以及目前针对动脉粥样硬化抗炎治疗的临床研究进展,以期为动脉粥样硬化治疗提供新的策略及靶点。     

免疫细胞在动脉粥样硬化炎症进展中的双刃剑作用

炎症在动脉粥样硬化发展过程中起到十分重要的作用.动脉粥样硬化病理过程由动脉内皮损伤和血浆胆固醇水平异常引起,随后通过炎症反应招募各种免疫细胞进入动脉内膜参与斑块的形成与进展,这些细胞包括巨噬细胞、树突状细胞、平滑肌细胞、T细胞、B细胞和肥大细胞等.其中每一种免疫细胞又由促炎亚群和抗炎亚群共同组成,并产生相应的促炎因子与...     

Toll 样受体配体与干扰素在脓毒症中的研究进展简

脓毒症是免疫功能紊乱致使促炎反应与抗炎反应失衡,炎症、免疫及组织损伤,最终导致全身炎症反应综合征的一种综合性疾病.研究表明,重症病房中,脓毒症患者占40%,其病死率为36%[1].然而,TLRs信号转导通路的过度刺激可能会破坏促炎和抗炎反应之间的平衡,最终导致自身免疫性疾病和炎症性疾病的发生.本文将阐述脓毒症中的相关研究进展.     

免疫细胞在血管性痴呆炎症反应中的调控作用

综述免疫细胞群及其诱导的细胞因子在血管性痴呆炎症反应中的调控机制、具有清热解毒功效的中药提取物及复方可通过调节免疫细胞群及其诱导的细胞因子发挥抗炎效应,表明神经免疫调节在血管性痴呆疾病发生发展中发挥着重要作用,运用清热解毒功效的中药提取物或复方对防治血管性痴呆和促进脑缺血、缺氧后神经功能恢复具有重要意义,提示可进一步发掘中药提取物或复方通过调节神经免疫防治血管性痴呆的研究方向,发挥中医药防治复杂性脑病的独特优势。     

白细胞介素37与动脉粥样硬化关系的研究进展

动脉粥样硬化(As)作为一种血管的慢性炎症性疾病,是冠心病、脑梗死、外周血管疾病的主要原因,严重威胁着人类的健康和生命。白细胞介素37是白细胞介素1家族的新型抗炎分子,在炎症性疾病、肿瘤、自身免疫性疾病中发挥抗炎及免疫抑制作用,该作用的发挥可能与白细胞介素18结合蛋白、Smad3相关。目前临床及动物试验均证实白细胞介素37参与了As的病理生理过程,可通过抑制巨噬细胞、肥大细胞、树突状细胞的功能,促进Treg细胞的分化而起到抗As的作用。本文拟对白细胞介素37与As关系的研究进展作一综述。     

炎性衰老机制与干预的实验研究

目的 运用基因芯片筛选与炎性衰老相关的炎性细胞因子与受体特征基因,探讨其炎性细胞因子网络调控机制;观察淫羊藿总黄酮(EF)和淫羊藿苷(Ica)对该网络的干预效果与机制.方法 SD大鼠分为4月龄(4 m)、24 m、24 m+EF和24 m+Ica组,每组10只.分别取各组大鼠海马和肺组织,用炎症细胞因子与受体基因芯片对各组组织分别进行基因表达检测.结果 (1)海马组织:24 m组与4 m组比较,促炎症细胞因子表达上调;同时抗炎症细胞因子下调.24 m+EF组、24 m+Ica组与24 m组比较,可见大量抗炎症细胞因子上调而促炎症细胞因子下调.(2)肺组织:24 m组与4 m组比较,促炎症细胞因子上调,同时抗炎症细胞因子下调.24 m+EF组、24 m+Ica组与24 m组比较,发现大量抗炎症细胞因子上调而促炎症细胞因子下调.结论 老年大鼠存在促炎性细胞因子基因表达上调和抗炎性因子表达下调,导致促-抗炎性细胞因子网络平衡失调;EF和Ica可能通过下调促炎性细胞因子基因表达和上调抗炎性细胞因子基因表达,重塑促-抗炎性细胞因子网络平衡而干预炎性衰老.     

高密度脂蛋白抗炎症到促炎症的转变

高密度脂蛋白具有抗炎症的特性.高密度脂蛋白促进胆固醇外流的功能对预防心血管疾病有重要的作用,同样,其抗炎症特性也具有非常重要的作用.高密度脂蛋白在免疫系统中发挥着重要的作用,在不发生急性相反应的条件下能发挥抗炎症作用,反之,则有促进炎症发生的作用.高密度脂蛋白的抗炎症特性主要是其内容物所决定的,在发生急性相反应时,其组成成分发生改变,从而促进了高密度脂蛋白从抗炎症到促炎症的转变.     

健脾解毒化瘀方对大鼠实验性溃疡性结肠炎细胞因子的影响

[目的]探讨以益气健脾、清热解毒、活血化瘀为原则组成方剂对溃疡性结肠炎(UC)大鼠细胞因子的影响,探讨其治疗UC的机制.[方法]除15只大鼠作为正常组外,其他大鼠采用TNBS复制UC模型后随机分成模型组、对照组、柳氮磺胺吡啶(SASP)组、中药组,肉眼及镜下观察各组大鼠的组织学损伤,并检测血清中细胞因子的含量.[结果]中药组、SASP组在减轻肉眼及镜下的组织学损伤方面和改善细胞因子方面较模型组、对照组均具有明显效果(P＜0.05);中药组较SASP组疗效更明显(P＜0.05).[结论]以益气健脾、清热解毒、活血化瘀为原则组成方剂对UC治疗有效,其机制可能是提高抗炎因子的含量,降低炎症因子的含量,维持细胞因子之间的平衡,进而调节免疫炎症反应.     

Emerging roles of vasoactive intestinal peptide: a new approach for autoimmune therapy

Identification of the factors that regulate the immune tolerance and control the appearance of exacerbated inflammatory conditions is crucial for the development of new therapies of autoimmune diseases. Some neuropeptides and hormones have emerged as endogenous agents that participate in the regulation of the processes that ensure self-tolerance. Among them, the vasoactive intestinal peptide (VIP), a well-characterised endogenous anti-inflammatory neuropeptide, has shown therapeutic potential for a variety of immune disorders. Here we examine the latest research findings, which indicate that VIP participates in maintaining immune tolerance in two distinct ways: by regulating the balance between pro-inflammatory and anti-inflammatory factors, and by inducing the emergence of regulatory T cells with suppressive activity against autoreactive T cell effectors.     

Emergence of cortistatin as a new immunomodulatory factor with therapeutic potential in immune disorders

Identification of the factors that regulate the immune tolerance and control the appearance of exacerbated inflammatory conditions is crucial for the development of new therapies of autoimmune diseases. Some neuropeptides and hormones have emerged as endogenous agents that participate in the regulation of the processes that ensure self-tolerance. Among them, cortistatin, an endogenous cyclic neuropeptide relative of somatostatin, has recently shown therapeutic potential for a variety of immune disorders. Here we examine the latest research findings, which indicate that cortistatin participates in maintaining immune tolerance in two distinct ways: by regulating the balance between pro-inflammatory and anti-inflammatory factors, and by inducing the emergence of regulatory T cells with suppressive activity against autoreactive T cell effectors.     

Neuropeptides as pleiotropic modulators of the immune response

Although necessary to eliminate pathogens, inflammation can lead to serious deleterious effects in the host if left unchecked. During the inflammatory response, further damage may arise from potential autoimmune responses occurring when the immune cells and molecules that respond to pathogen-derived antigens also react to self-antigens. In this sense, the identification of endogenous factors that control exacerbated immune responses is a key goal for the development of new therapeutic approaches for inflammatory and autoimmune diseases. Some neuropeptides that are produced during the ongoing inflammatory response have emerged as endogenous anti-inflammatory agents that could collaborate in tuning the balanced steady state of the immune system. These neuropeptides participate in maintaining immune tolerance through two distinct mechanisms: by regulating the balance between pro-inflammatory and anti-inflammatory factors, and by inducing the emergence of regulatory T cells with suppressive activity against autoreactive T cell effectors. Indeed, a functioning neuropeptide system contributes to general health, and alterations in the levels of these neuropeptides and/or their receptors lead to changes in susceptibility to inflammatory and autoimmune diseases. Recently, we found that some neuropeptides also have antimicrobial and antiparasitic actions, suggesting that they could act as primary mediators of innate defense, even in the most primitive organisms. In this review, we use the vasoactive intestinal peptide as example of an immunomodulatory neuropeptide to summarize the most relevant data found for other neuropeptides with similar characteristics, including adrenomedullin, urocortin, cortistatin and ghrelin.     

固有免疫介导的炎症反应在动脉粥样硬化发病机制中的研究进展

动脉粥样硬化是常见慢性心脑血管疾病的病理基础,其病变始于血管内皮细胞构成的天然屏障功能障碍,由各种损伤因子影响内皮细胞Caspase-1/Sirt1/AP-1、SREBP2/NOX2/NLRP3、KLF2/FoxP1/NLRP3、NFAT5/NLRP3等通路信号转导、相关炎症基因表达,激活内皮细胞,继而单核细胞浸润主动脉壁内膜下并分化为巨噬细胞,引起相应内皮激活的固有免疫反应,在NLRP3/ASC/Caspase-1炎性小体途径激活后,使促炎症细胞因子IL-1β、IL-18释放增加,介导下游炎症因子、趋化因子等表达增加,促进动脉粥样硬化炎症反应;血管壁持续慢性炎症反应使血管平滑肌细胞表型转变,促进动脉粥样硬化斑块形成,还使斑块成分发生改变、易损性增加,斑块微钙化则增加了斑块处血管应力,破裂危险增加。本文综述了固有免疫介导的动脉粥样硬化炎症机制研究现状,为动脉粥样硬化抗炎药物研发提供思路以及促进抗动脉粥样硬化研究的实验设计。     

Inflammation as a link between obesity,metabolic syndrome and type 2 diabetes

It is recognized that a chronic low-grade inflammation and an activation of the immune system are involved in the pathogenesis of obesity-related insulin resistance and type 2 diabetes. Systemic inflammatory markers are risk factors for the development of type 2 diabetes and its macrovascular complications. Adipose tissue, liver, muscle and pancreas are themselves sites of inflammation in presence of obesity. An infiltration of macrophages and other immune cells is observed in these tissues associated with a cell population shift from an anti-inflammatory to a pro-inflammatory profile. These cells are crucial for the production of pro-inflammatory cytokines, which act in an autocrine and paracrine manner to interfere with insulin signaling in peripheral tissues or induce β-cell dysfunction and subsequent insulin deficiency. Particularly, the pro-inflammatory interleukin-1β is implicated in the pathogenesis of type 2 diabetes through the activation of the NLRP3 inflammasome. The objectives of this review are to expose recent data supporting the role of the immune system in the pathogenesis of insulin resistance and type 2 diabetes and to examine various mechanisms underlying this relationship. If type 2 diabetes is an inflammatory disease, anti-inflammatory therapies could have a place in prevention and treatment of type 2 diabetes.     

炎症反应在易损斑块中的作用及其机制研究进展

炎症反应在易损斑块的形成和进展中发挥重要作用,同时调控血管局部病变及全身炎症状态。一些促炎性细胞和炎症因子使斑块纤维帽的抗张强度降低,坏死脂质内核增大,血管机械稳定性丧失和斑块破裂;另一方面,炎症反应的激活和代谢紊乱也会引起内皮功能不全、斑块侵蚀进而导致血栓形成。该过程主要由巨噬细胞和淋巴细胞等多种炎症细胞参与,并受到多种因素调控,包括胆固醇结晶和脂质递质、血管剪切力、血管新生及斑块内出血等。此外,机体还存在一些抑炎性分子,能避免易损斑块向破裂或侵蚀进展。促炎和抗炎反应的平衡影响急性冠状动脉事件的发生。因此,以炎症反应为靶点,筛选出有易损斑块的患者并干预,或可减少急性冠状动脉事件的发生和改善预后,具有重要临床价值。     

Regulation of the intestinal immune system by flavonoids and its utility in chronic inflammatory bowel disease

Flavonoids are phytochemicals which can regulate the activity of the intestinal immune system. In patients with chronic inflammatory bowel disease(IBD) there is an overexpression and imbalance of the components of the inflammatory immune reactions which are chronically activated. Suppression of inflammation can be achieved by anti-inflammatory drugs which are used in clinical medicine but these can cause serious side effects. Flavonoids can have natural immunosuppressive properties and inhibit the activation of immune cells and its effectors(chemokines, TNF-, cytokines). Phytochemicals such as flavonoids bind to the nuclear Ah(aryl hydrocarbon)-receptor thereby stimulating protective enzyme activities. As shown by clinical evidence in patients and by experimental work some flavonoids(apigenin, epigallocatechin gallate) were effective in the inhibition of inflammation. Instead of or additionally to anti-inflammatory drugs flavonoids can be used in IBD patients to treat the over-reactive immunologic system. This is accomplished by upregulation of the Ah-receptor. Flavonoids interact with toll-like receptors expressing on the surface of immune cells, then they were internalized to the cytosol and transferred into the nucleus, where they were attached to the Ah-receptor. The Ah-receptor binds to the Ah-R nuclear translocator and via Ah response element beneficial protective enzymes and cytokines are induced, leading to upregulation of the anti-inflammatory system.