胆碱能系统对脓毒症炎症与免疫调控机制的研究进展被引量：3

Review of the Regulation Mechanism of Cholinergic System on Inflammation and Immunity in Sepsis

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摘要炎症与免疫功能紊乱是脓毒症致死、致残的根本原因,近年来研究发现,胆碱能系统能实时、动态地调控脓毒症的炎症与免疫,一方面迷走神经借助胆碱能抗炎通路(CAP)和α7-烟碱样乙酰胆碱受体(nAChRs)而感知和调节局部或全身炎症;另一方面脑内乙酰胆碱作用于前脑胆碱能神经元毒蕈碱型乙酰胆碱受体亚型M1(M-AchRM1),通过影响延髓内脏带(MVZ)而间接调控炎症与免疫。笔者分析既往文献发现,MVZ是神经系统调控炎症与免疫的初级中枢与中心环节,是协调交感与迷走神经系统、神经与神经-内分泌系统对炎症与免疫调控的关键枢纽;α7-nAChRs广泛表达于免疫细胞、神经元和肌细胞中,能调控局部组织炎症和系统性炎症,并能反映组织急/慢性炎症状态;M-AchRM1主要在高级神经中枢中表达并调控系统性炎症;脓毒症可诱导MVZ、下丘脑及前脑的神经炎症,导致其调控紊乱,这可能是脓毒症炎症与免疫紊乱的根本机制,故着力于α7-nAChRs和M-AchRM1的调控可能成为未来脓毒症诊疗的重要策略。 Regulatory dysfunction of inflammation and immunity should be responsible for the heavy deaths and disabilities in sepsis.In recent years,studies have found that the body's cholinergic system can spontaneously and dynamically regulate the inflammation and immunity in sepsis according to the needs of the body.On the one side,the vagus nerve senses and regulates local or systemic inflammation by means of cholinergic anti-inflammatory pathway(CAP)and activation ofα7-nicotinic acetylcholine receptors(α7-nAChRs);on the other hand,neurotransmitters of acetylcholine in the brain act on muscarinic acetylcholine receptors M1(M-AchRM1)of cholinergic neuron in the forebrain,and indirectly regulates inflammation and immunity by affecting the medullary visceral zone(MVZ).The author analyzed the previous literatures and found that,MVZ is the primary center and linking hub for the nervous system to regulate inflammation and immunity.It coordinates not only the sympathetic system and vagus system,but also the auto-nervous system and the neuroendocrine system to regulate inflammation and immunity;α7-nAChRs is widely expressed in immune cells,neurons and muscle cells,it can regulate local and systemic inflammation,in addition,it can reflect the acute and chronic inflammatory state of the tissue;M-AchRM1 is mainly expressed in the advanced central nervous system and regulates systemic inflammation;sepsis induces neuroinflammations in MVZ,hypothalamus,and forebrain,which contribute to their individual dysfunctions and may be the fundamental mechanism of the regulatory dysfunction of systemic inflammation and immune.Focusing on the regulation ofα7-nAChRs and M-AchRM1 may be a key strategy for the treatment of sepsis in the future.

作者张胜凯李红兵张程张巍 ZHANG Shengkai;LI Hongbing;ZHANG Cheng;ZHANG Wei(Department of Emergency,Ezhou Central Hospital,Ezhou 436000,China;Department of Emergency,the First People's Hospital of Guiyang,Guiyang 550002,China)

机构地区湖北省鄂州市中心医院急诊科贵州省贵阳市第一人民医院急诊科

出处《实用心脑肺血管病杂志》 2021年第10期132-140,共9页 Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基金贵州省科技厅科研课题(黔科合基础[2019]1005) 贵州省卫健委科学技术基金(gzwkj2021-001)。

关键词脓毒症胆碱能系统胆碱能抗炎通路炎症免疫综述 Sepsis Cholinergic system Cholinergic anti-inflammatory pathway Inflammation Immunity Review

分类号 R631 [医药卫生—外科学]

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参考文献3

1李红兵,李媛,王武石,彭宗爽,吴芳.胆碱能抗炎通路对脓毒症大鼠早期炎症与免疫反应具有负向调控作用[J].南方医科大学学报,2020,40(5):647-653. 被引量：15
2Yang Sun,Qi Li,Huan Gui,Dong-Ping Xu,Yi-LiYang,Ding-Feng Su,Xia Liu.MicroRNA-124 mediates the cholinergic anti-inflammatory action through inhibiting the production of pro-inflammatory cytokines[J].Cell Research,2013,23(11):1270-1283. 被引量：38
3马度芳,姜萍,杨金龙,李晓.调节自主神经系统:心血管疾病抗炎治疗的新领域[J].中国病理生理杂志,2015,31(2):374-378. 被引量：19

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