内皮祖细胞与动脉粥样硬化及他汀类药物的干预

Influence of statins on atherosclerosis through endothelial progenitor cells

学术背景:内皮损伤是动脉粥样硬化的始动因子,内皮祖细胞作为血管内皮的前体细胞,在内皮修复和血管新生中起重要作用。他汀类药物通过内皮祖细胞对动脉粥样硬化的影响是最新的研究热点。目的:总结他汀类药物通过内皮祖细胞对动脉粥样硬化影响的研究进展。检索策略:应用计算机检索Pubmed、OVID数据库2000-01/2006-12的相关文献,检索词"endothelial progenitor cells,statins,atherosclerosis",限定文章语言种类为English,同时计算机检索CNKI,维普数据库2000-01/2006-12期间的相关文章,检索词"内皮祖细胞;动脉粥样硬化;他汀类药物",限定文章语言种类为中文。共检索到62篇文献,对资料进行初审,纳入标准:①与他汀类药物通过内皮祖细胞对动脉粥样硬化的影响密切相关。②同一领域选择近期发表或在权威杂志上发表的文章。排除标准:重复性研究。文献评价:文献的来源主要是他汀类药物通过内皮祖细胞对动脉粥样硬化的影响。所选用的28篇文献均为临床或基础实验研究,2篇为综述。资料综合:①在生理情况下,内皮的完整性可以有临近内皮细胞的再生来维持,然而在氧化应激情况下,内皮祖细胞的归巢可以保护损伤的内皮完整性。②他汀类药物通过动员内皮祖细胞修复损伤的血管内皮,从而延缓动脉粥样硬化的进一步发展。③他汀类药物通过PI3K/Akt途径动员骨髓中的内皮祖细胞和抑制内皮祖细胞凋亡,使血液循环中的内皮祖细胞的数量增多,促使内皮祖细胞归巢至心肌缺血部位,促进新生血管的生成,改善缺血心肌的血液供应,从而改善心室收缩功能。结论:他汀类药物通过动员内皮祖细胞增加血液循环中内皮祖细胞的数量和抑制内皮祖细胞凋亡从而延缓动脉粥样硬化的进展,减少动脉粥样硬化患者的死亡率和改善其愈后,具有广泛的研究前景。

BACKGROUND： Endothelium damage is the promoter of atherosclerosis, and endothelial progenitor cells as vascular endothelium precursor cells play an important role in endothelium repair and angiogenesis. The influence of statins on atherosclerosis through endothelial progenitor cells is the new research hot spot. OBJECTIVE： To summarize the research progress of statins through endothelial progenitor cells on atherosclerosis. RETRIEVAL STRATEGY： A computer-based search of Pubmed and Ovid database from January 2000 to December 2006, with the retrieval word of ＂endothelial progenitor cells, statins, atherosclerosis＂, and language was limited in English. Meanwhile CNKI and VIP database were retrieved from January 2000 to December 2006, the retrieval words were ＂endothelial progenitor cells, atherosclerosis, statins＂ in Chinese. Totally 62 articles were retrieved and checked primarily. Inclusive criteria： ①articles closely related to the influence of statins through endothelial progenitor cells on atherosclerosis;②articles published recently or in authorities journal were preferred in the same field. Exclusive criteria： repetitive research. LITERATURE EVALUATION： The mainly resource of documents is the influence of statins on atherosclerosis through endothelial progenitor cells. All 28 included documents were clinical or basic empirical studies, and 2 were reviews. DATA SYNTHESIS： Under physiological conditions, the integrity of the endothelial monolayer can be maintained by reproduction of adjacent cells. However, in conditions of oxidative stress damage, the integrity of the endothelium is prevented by progenitor cell homing.Statins mobilize endothelial progenitor cells to repair impaired endothelium and then postpone atherosclerotic progress. Statins mobilize endothelial progenitor cells through PI3K/Akt pathway and suppress endothelial progenitor cell apoptosis, leading to increase the number of endothelial progenitor cells in blood circulation, precipitate endothelial progenitor cells homing to myocardial ischemia site, promote new vascular generation, ameliorate blood supply of ischemia myocardium, and ameliorate the function of ventricular contraction. CONCLUSION： Through mobilizing endothelial progenitor cells, statins can increase the number of endothelial progenitor cells in blood circulation and suppress endothelial cells apoptosis, so as to postpone the progress of atherosclerosis, decrease the mortality rate of atherosclerosis patients, and improve their prognosis, which all indicate a wide research prospect.