血栓闭塞性脉管炎发病机制和治疗的研究新进展

New progress in pathogenesis and treatment of thromboangiitis obliterans

血栓闭塞性脉管(TAO)是一种以血管内皮细胞为基础的血管的炎性疾病,机制不清。近年来关于TAO发病机制的研究多面向于免疫方向和炎症方向。本综述阐述了关于TAO发病机制的新发现及治疗的新靶点。最新研究发现感染是TAO发病的一个重要机制,多见于革兰氏阴性菌的感染,除此之外,还有立克次体等其他致病菌的感染。IL-6/STAT3通路可以调控TAO内皮细胞粘附分子和细胞骨架来参与TAO的发病。血浆中血红蛋白及NO的含量也会影响TAO的病程发展。TAO的发生是一个多种致病因素共同作用的结果,其治疗方法也很多样,虽不能根治,但效果显著,如ADAM10对TAO病理改变的调节、药物治疗和干细胞对损伤组织的重建。改善血运在治疗TAO中也扮演着很重要的角色。本文就TAO的发病机制及治疗进展综述如下。

Thromboangiitis obliterans(TAO) is an inflammatory symptom of blood vessels based on vascular endothelial cells,and the mechanism of it is ambiguous. In recent years, the research on the pathogenesis of TAO is mostly oriented to immunity and inflammation. This review describes the new findings on the pathogenesis of TAO and new targets for treatment. The latest studies have found that infection is an important factor of TAO, more common in Gram-negative bacteria infection, in addition to Rickettsia and other pathogenic bacteria infection. IL-6/STAT3 pathway can regulate endothelial cell adhesion molecules and cytoskeleton in TAO to participate in the pathogenesis of TAO. The content of hemoglobin and NO in plasma will also affect the course of TAO. The occurrence of TAO is the result of a variety of pathogenic factors, and its treatment methods are also very diverse, although it can not be cured, but the effect is remarkable, such as the regulation of pathological changes of TAO by ADAM10, drug treatment and the reconstruction of damaged tissue by stem cells. Improving blood flow also plays an important role in the treatment of TAO. The pathogenesis and treatment progress of TAO are summarized as follows.