胆碱能抗炎通路的机制及其在脓毒症的应用

Mechanism of the cholinergic anti-inflammatory pathway and its application in sepsis

胆碱能抗炎通路是近年来发现的对全身性炎症反应有调节作用的通路,可通过迷走神经抑制促炎细胞因子的合成从而抑制机体炎症反应。核因子-κB和Janus激酶/信号转导与转录激活子是该通路细胞内信号转导中最重要的两条信号通路。脓毒症以全身炎症反应为特点,是危重症患者的常见死因。根据胆碱能抗炎通路作用迅速有效的特点,推测其可应用于脓毒症的治疗。目前已有多项实验研究的结果表明:物理方法如电刺激迷走神经,药物如乙酰胆碱受体激动剂、胆碱酯酶抑制剂、生长激素释放肽和不饱和脂肪酸的应用,均可有效抑制脓毒症的发展。

The cholinergic anti-inflammatory pathway is a recently discovered regulatory pathway of systemic inflammatory response.It can inhibit the inflammatory response by supressing the synthesis of pro-inflammatory cytokines through the vagus nerve.Nuclear factor kappa B（NF-κB）and Janus kinase/signal transducers and activators of transcription（JAK/STAT） are the most important signal pathways in the intracellular signal transduction of this anti-inflammatory pathway.Characterized by systematic inflammatory response,sepsis is a frequent cause of death for patient under critical conditions.Due to its rapid and effective activity,the cholinergic anti-inflammatory pathway could be a promising target for the treatment of sepsis.Based on this pathway,experimental studies have revealed many possible effective treatments for sepsis,including physical therapy such as electrical stimulation to the vagus nerve,drugs such as acetylcholine receptor agonist,cholinesterase inhibitors,ghrelin and unsaturated fatty acids.