内质网应激与糖尿病动脉粥样硬化研究进展

Role of endoplasmic reticulum stress in diabetic atherosclerosis

心血管疾病是糖尿病患者的主要死因，然而糖尿病并发动脉粥样硬化的分子和细胞机制现在仍未明确。内质网应激可能在高血糖、糖尿病与动脉粥样硬化之间扮演了中间枢纽的作用。糖尿病的高血糖所诱导的葡糖胺途径以及糖尿病引起的巨噬细胞胰岛素抵抗均能诱发内质网应激。研究发现内质网应激所产生的非折叠蛋白反应贯穿动脉粥样硬化发展的全过程，并且内质网应激所引起的脂质沉积、细胞凋亡、炎性反应正是动脉粥样硬化形成的标志。尽管内质网应激可能在糖尿病促发动脉粥样硬化的过程中有巨大作用，但每条具体通路所起的作用及各个因子相互之间的作用仍需研究，这样才能为我们治疗或预防糖尿病心血管并发症提供独特的个体化治疗方案。

The diabetic patients died of cardiovascular disease mainly. However, the molecular and cellular mechanisms of diabetes complicated with atherosclerosis were still unclear. Endoplasmic reticulum （ER） stress may play a vital intermediate role in the progression of diabetic atherosclerosis. Both of diabetic hyperglycemia induced hexosamine pathway and diabetes induced macrophage insulin resistance can lead to ER stress. The unfolded protein response （UPR） produced by ER stress can be observed throughout the whole development course of atherosclerosis. In addition, ER stress also induced lipid deposition, cell apoptosis and inflammatory response, all of which was important for the progression of atherosclerosis. Though ER stress may be key for diabetes induced atherosclerosis, which pathway played the central role and the interaction between cytokines still need to be investigated. So that we could provide individual therapeutic scheme for treatment as well as prevention of diabetic complication.