基于外泌体介导的巨噬细胞极化探讨针刺治疗慢性阻塞性肺疾病的潜在机制

慢性阻塞性肺疾病(Chronic obstructive pulmonary disease, COPD)以肺结构退行性病变、炎症和纤维化为特征, 是危害人类健康的重要呼吸系统疾病。与服用药物相比, 针刺能够改善呼吸困难, 提高患者的运动耐力以及机体免疫力且副作用较小, 但其作用机制尚不明确。炎症机制在COPD的发生中十分重要, 其中巨噬细胞是重要的炎症参与者，巨噬细胞极化在COPD的发病过程中具有关键作用。外泌体为可由多种细胞分泌的纳米级双层膜囊泡, 能够介导细胞间或器官间通讯, 调节细胞功能或细胞活动。据报道外泌体参与巨噬细胞极化, 具有调节炎症的作用。在影响COPD发生发展的机制研究中, 外泌体作为重要的突破点已受到越来越多的关注。因此主要从外泌体参与巨噬细胞极化角度出发, 阐释COPD的发病机制以及分析针刺通过调控外泌体, 参与巨噬细胞极化, 从而治疗COPD的可行性。 

Potential Mechanism of Acupuncture Treatment for Chronic Obstructive Pulmonary Disease Based on Exosome-Mediated Macrophage Polarization

Chronic obstructive pulmonary disease (COPD) is an important respiratory disease that endangers human health, characterized by degenerative changes, inflammation and fibrosis of lung structure. Compared with taking medicine, acupuncture can improve dyspnea, exercise endurance and immunity of patients with less side effects, but its mechanism is not clear. Inflammatory mechanisms play an important role in the development of COPD, in which macrophages are important inflammatory participants. Macrophages are highly plastic and can polarize into M1-type macrophages and M2-type macrophages when stimulated by the microenvironment. After activation, M1 macrophages can release pro-inflammatory cytokines and have pro-inflammatory effects. M2 macrophages have anti-inflammatory and immunomodulatory functions. Macrophage polarization plays a key role in the pathogenesis of COPD. Exosomes are nanoscale double-membrane vesicles that can be secreted by a variety of cells, which can mediate intercellular or interorgan communication, regulate cell function or cell activity. Exosomes have been reported to be involved in macrophage polarization and have a role in regulating inflammation. As an important breakthrough, exosomes have attracted more and more attention in mechanism study of the development of COPD. Therefore, from the point of view of exosomes participating in macrophage polarization, our study explain the pathogenesis of COPD and analyzes the feasibility of acupuncture in the treatment of COPD by regulating exosomes which participants in macrophage polarization.