由SR-BⅠ介导的胆固醇外流途径与系统性红斑狼疮患者动脉粥样硬化的相关性研究进展

Research progress on correlation between SR-BⅠmediated cholesterol efflux pathway and atherosclerosis in patients with systemic lupus erythematosus

系统性红斑狼疮是一种涉及多系统损害的慢性、反复迁延的自身免疫性疾病。系统性红斑狼疮患者主要的死亡原因是多脏器严重损害和感染,而远期的死亡原因有慢性肾功能不全、药物不良反应和其他并发症(包括动脉粥样硬化性心脏病、高血压、糖尿病等),这与患者早发和高发血脂紊乱,以及血浆中高密度脂蛋白水平有密切的联系。人体内的胆固醇主要的代谢去路是通过血浆中高密度脂蛋白将肝外组织和细胞内的胆固醇通过血液循环运送到肝脏,在肝脏中转化成胆汁酸,随胆汁排出,这个过程为胆固醇逆向转运。大量研究表明将胆固醇从肝外细胞移出至高密度脂蛋白、载运胆固醇酯化及胆固醇酯的转运等过程均需要B类Ⅰ型清道夫受体(SR-BⅠ)的参与。现综述SR-BⅠ在胆固醇外流途径中的作用,以及系统性红斑狼疮患者发生动脉粥样硬化与SR-BⅠ介导的胆固醇外流途径障碍的相关性。

Systemic lupus erythematosus(SLE)is a chronic and repeated autoimmune disease with multiple system damage.The main death causes of the patients with SLE are severe multi-organ damage and infection.However,the long-term causes of death included the chronic renal insufficiency,drug adverse reactions and other complications(including atherosclerotic heart disease,hypertension,diabetes,etc.),which is closely related to the early-onset,high occurrence of dyslipidemia and plasma high density lipoprotein level.The main metabolic outlet of cholesterol in the human body is that extrahepatic tissue and intracellular cholesterol is transported to the liver by plasma high density lipoprotein,converted into bile acid in the liver and excreted with bile.This process is the reverse cholesterol transport.A large number of studies have shown that the transport processes such as the migration of cholesterol from extrahepatic cells to high density lipoprotein,cholesterol esterification and cholesterol ester transport need the participation of scavenger class B typeⅠreceptor(SR-BⅠ).This paper reviews the role of SR-BⅠin the outflow pathway of cholesterol,as well as the correlation between the development of atherosclerosis and impairment of SR-BⅠmediated cholesterol efflux pathway in patients with systemic lupus erythematosus.