基于胆碱能抗炎通路探索脓毒症治疗的研究进展

Research progress of exploring the treatment of sepsis based on cholinergic anti-inflammatory pathway

胆碱能抗炎通路(CAP)是经迷走神经传出、脾神经中继支配脾脏,由脾脏T细胞将肾上腺素能刺激转换为胆碱能信号作用于巨噬细胞等,发挥抗炎效应,保持机体炎症反应平衡的重要神经免疫调节机制。由于促炎与抗炎反应失衡在脓毒症病生理过程中的关键性作用,调节CAP活性成为目前脓毒症治疗研究的重要着眼点。基于对CAP的认识,目前迷走神经刺激、药物激动剂模拟胆碱能信号和针刺等被应用于脓毒症治疗的研究探索中。本文对近年来有关CAP机制、生物学效应及其在脓毒症治疗中应用的研究进行综述。

The cholinergic anti-inflammatory pathway(CAP)is an important neuroimmunomodulatory mechanism that innervates the spleen through vagus nerve efferent and splenic nerve relay,and acts on macrophages by transforming adrenergic stimulation into cholinergic signal by spleen T cells,which plays an anti-inflammatory effect,and maintains the balance of inflammatory response.Due to the critical role of the imbalance of pro-inflammatory and anti-inflammatory responses in the physiological process of sepsis,regulating the activity of the CAP has become an important focus in the treatments of sepsis.Based on the understanding of the CAP,vagus nerve stimulation,drug agonists mimicking cholinergic signals,and acupuncture are currently applied in the research and exploration of sepsis treatment.This article summarizes the recent progress and prospects of the CAP mechanism,biological effects,and application in sepsis treatment.