胰腺星状细胞微环境与慢性胰腺炎

Microenvironment of pancreatic stellate cells in chronic pancreatitis

慢性胰腺炎(chronic pancreatitis,CP)是各种病因引起胰腺组织和功能不可逆改变的慢性炎症性疾病.基本病理特征包括胰腺实质慢性炎症损害和间质纤维化、胰腺实质钙化、胰管扩张及胰管结石等.胰腺纤维化的形成是一个以胰腺星状细胞(pancreatic stellate cells,PSCs)为中心由复杂的信号网络通路所介导,多种细胞因子与炎症介质参与,最终以成纤维细胞增生和细胞外基质沉积为特征的复杂的病理发展过程,但尚无一个较为统一的学说来解释胰腺炎的发病机制.PSCs活化是CP纤维化发生的关键步骤,因此,PSCs所在微环境的调控在纤维化过程中的作用成为研究热点.研究纤维化相关的信号因子和通路,并试图通过这些分子和通路来抑制或者逆转PSCs的激活,以达到阻止或延缓纤维化进程的目的.许多新的治疗药物已被尝试用于CP,但大多数仍处于实验阶段.作用于PSCs的疗法最有希望在不久的将来转化为临床使患者获益.

Chronic pancreatitis（CP） is a chronic inflammatory disease that is caused by various factors and has irreversible changes in pancreatic tissue and function. The basic pathological features of CP include chronic inflammatory lesions and interstitial fibrosis of the pancreas,calcification of the pancreatic parenchyma,dilatation of the pancreatic duct, and stones in the pancreatic duct. Pancreatic stellate cells（PSCs） play a central role in pancreatic fibrosis that is mediated by a complex signal pathway network including a variety of cytokines and inflammatory mediators. This complex pathological process is characterized by the proliferation of fibroblasts and extracellular matrix deposition. There is no unified theory to explain the pathogenesis of pancreatitis.Since PSC activation is a key step of fibrosis in CP, the study on the microenvironment of PSCs in the regulation of fibrosis process has become a hot topic. Studies on inhibition or reversion of PSC activation have been carried out to prevent or delay the progression of fibrosis through different molecules and pathways. Many new therapies have been tried for CP, most of which are still in the experimental stage. Therapies targeting PSCs are most promising to benefit patients in the near future.