血管生成素-Tie通路在冠心病中的作用机制及意义

Mechanism and significance of angiopoietin-Tie pathway in coronary heart disease

冠心病作为常见的心血管病,其患病率和死亡率仍呈上升趋势,冠心病的防治已成为全社会研究的重要课题。从血管新生的角度研究冠状动脉粥样硬化、急性心肌梗死、心梗所致心源性休克等的发病机制具有很大的临床意义,而治疗性血管新生可为冠心病患者提供新的治疗选择。血管生成素(angiopoietins,Angs)-Tie通路是参与血管新生过程的重要信号传导通路,主要包括Ang1、Ang2、Ang3、Ang4及其受体Tie1、Tie2。目前研究较多的有Ang1、Ang2和Tie2,其中Ang1-Tie2主要维持脉管系统稳定,Ang2-Tie2与血管重塑密切相关。动脉粥样硬化病变中的斑块生长和斑块不稳定都涉及到了新血管形成。Angs是从斑块形成的初始阶段到急性心血管事件发生过程中的关键因素。Angs在不稳定型心绞痛、急性心肌梗死、心梗所致心源性休克的发病过程中都起到了关键作用,Angs还可以作为上述疾病发生发展的新指标。在治疗方面,Angs-Tie通路是冠状动脉粥样硬化早期预防,心梗后改善心脏灌注及功能,和促进侧支循环建立等的潜在治疗靶点。本文将对Angs-Tie通路在冠心病及相关疾病中的作用及临床意义作一综述。

As a common cardiovascular disease, coronary heart disease(CHD) continues to be the leading cause of mortality as well as morbidity. The prevention and treatment of coronary heart disease(CHD) has become an important topic in the whole society. It is of great clinical significance to associate angiogenesis with the pathogenesis of coronary atherosclerosis, acute myocardial infarction(AMI), and cardiogenic shock after AMI. Therapeutic angiogenesis may provide new treatment options for patients with coronary heart disease. Angiopoietin(Angiopoietins, Angs)-Tie pathway is an important signal transduction pathway involved in angiogenesis, including Ang1, Ang2, Ang3, Ang4 and its receptor Tie1, Tie2. At present, there are more studies on Ang1, Ang2 and Tie2, in which Ang1-Tie2 mainly maintains vascular system stability, and Ang2-Tie2 is closely related to vascular remodeling. Both plaque growth and instability in atherosclerosis involve neovascularization. Angs is a key factor from the initial stage of plaque formation to the occurrence of acute cardiovascular events. Angs also plays a key role in the pathogenesis of unstable angina pectoris cardiogenic, AMI, and cardiogenic shock after AMI. Angs can become a new indicator of the occurrence and development of these diseases. In treatment, Angs-Tie pathway is a potential therapeutic target for early prevention of coronary atherosclerosis, improvement of cardiac perfusion and function after myocardial infarction, and promotion of collateral circulation. This article reviews the mechanism and significance of Angs-Tie pathway in coronary heart disease.