外泌体在慢性病发生发展中的调控作用及临床辅助诊疗研究进展

Role of exosome regulation mechanism in chronic diseases and its clinical application prospect

慢性病逐渐成为世界范围内致死的主要因素,外泌体(EXs)在慢性病的调控机制和潜在治疗作用已逐步进入研究者视野。外泌体是一种具有脂质双分子层膜结构的纳米级微小膜泡,包含多种蛋白质、脂质和核酸,可由多种细胞分泌。外泌体能促使类似"细胞–细胞或组织–组织的信息物流"现象的发生,在调控糖尿病、中枢神经系统疾病、慢性阻塞性肺疾病及心脑血管疾病等多种慢性病的发生发展过程中作用显著。检索PubMed及CNKI期刊全文数据库,以"外泌体、慢性病、致病、生物标志物和治疗"为关键词,期限为2012–01—2019–01。文献纳入标准:(1)EXs的生物学功能;(2)EXs在慢性病中的致病机制;(3)EXs作为慢性病生物标志物的应用研究;(4)EXs作为慢性病治疗载体和药物靶点的研究。根据纳入标准,纳入文献353篇。外泌体作为细胞间信息交流的载体,在慢性病的发生发展过程中的调控作用不可忽视。外泌体可以作为慢性病研究、诊断及治疗的理想靶点,但其临床检测手段和应用仍有许多问题需要解决。

Researches indicate that chronic diseases have been becoming leading cause of mortality worldwide. The regulatory mechanism and potential clinical application of exosomes(EXs) in chronic diseases have seized the eyes of researchers. Capsulated by lipid bilayers, EXs contain several kinds of cargoes, including multiple proteins, lipids and nucleic acid, and can be secreted by various cells. EXs promote the occurrence of "cell to cell or tissue to tissue information flow",thus playing a critical role in the incidence and evolution of a diversity of chronic diseases, such as diabetes, central nervous system(CNS) disease, chronic obstructive pulmonary disease(COPD), cardiac-cerebral vascular disease. We searched PubMed and China National Knowledge Infrastructure(CNKI) periodical full-text database retrieval system with exosomes,chronic diseases, pathogenesis, biomarkers and treatment as keywords, from January 2012 to January 2019. The including criteria are(1) the biological function of EXs;(2) the pathogenesis of EXs in chronic diseases;(3) the application of EXs as a biomarker for chronic diseases;and(4) the use of EXs as a carrier and drug target for chronic diseases. A total of 353 literatures were included in the study. As a carrier in intercellular communication, EXs cannot be ignored in the development and progression of chronic diseases. EXs can be an ideal target for the diagnosis and treatment of chronic diseases, but so far,there are still many problems to be solved in clinical detection methods and applications.