外泌体调控铁死亡在疾病诊断治疗中的应用与作用

Application and role of exosome-regulated ferroptosis in disease diagnosis and treatment

背景:目前已有研究在揭示外泌体与铁死亡的关系,但研究仍有限,因此进一步探析二者的关系,有助于为疾病的临床治疗寻求新的治疗策略和可靠依据。目的:阐明了外泌体的生物学特性、铁死亡的发生机制,以及外泌体调控铁死亡的主要途径,综述了外泌体诱导或抑制铁死亡在肿瘤、心血管系统、神经系统疾病及肝脏疾病等领域诊断治疗中的应用进展。方法:运用计算机检索PubMed及中国知网数据库,以“Exosomes,Ferroptosis,Disease”为英文检索词,以“外泌体、铁死亡、疾病”为中文检索词,最终纳入与综述目的相关的66篇文献进行综述。结果与结论:①外泌体通过参与铁代谢、脂质代谢及氨基酸代谢等途径,起到调节细胞铁死亡的作用。②外泌体通过诱导或抑制细胞铁死亡在各种疾病的治疗中发挥了重要作用,具体体现在:外泌体诱导了癌细胞铁死亡,抑制了肿瘤的生长及转移,提高了肿瘤靶向治疗的效果;外泌体通过抑制铁死亡在心血管疾病方面,促进了心肌缺血组织再灌注的再生修复,降低了心脏毒性;在神经系统疾病中,发挥了抑制脑出血、减轻脓毒症的作用;在肝脏疾病中,发挥了改善肝脏缺血再灌注的作用。③外泌体调控铁死亡在各种疾病中发挥作用的具体机制尚未完全探明,一些相关研究尚处于初步阶段,但外泌体调控铁死亡在未来有望成为各种疾病临床治疗的新潜在靶点之一。

BACKGROUND:At present,studies have been done to reveal the relationship between exosomes and ferroptosis,but the research is still limited.Therefore,further exploration of the relationship between exosomes and ferroptosis will help to seek new treatment strategies and reliable basis for clinical treatment of diseases.OBJECTIVE:To expound the biological characteristics of exosomes,the mechanism of ferroptosis,and the main ways of exosomes regulating ferroptosis,and summarize the application progress of exosomes inducing or inhibiting ferroptosis in the fields of tumor,cardiovascular system,nervous system disease and liver disease.METHODS:Relevant articles were retrieved in CNKI and PubMed using computer.Search terms included“exosomes,ferroptosis,disease”in Chinese and English.Finally,66 articles related to the research purpose of the article were included for further review.RESULTS AND CONCLUSION:(1)Exosomes play a regulatory role in promoting cell ferroptosis by participating in iron metabolism,lipid metabolism and amino acid metabolism.(2)Exosomes play an important role in the treatment of various diseases by inducing or inhibiting ferroptosis:on the one hand,exosomes induce ferroptosis of cancer cells,inhibit tumor growth and metastasis,and improve the effect of tumor targeted therapy.On the other hand,by inhibiting ferroptosis,exosomes promote the regeneration and repair of myocardial ischemia-reperfusion and reduce cardiac toxicity in cardiovascular disease.In terms of nervous system diseases,it has played a role in inhibiting cerebral hemorrhage and reducing sepsis.In liver diseases,it can improve hepatic ischemiareperfusion.(3)Although the specific mechanism by which exosomes regulate ferroptosis in various diseases has not been fully explored,and the relevant research is still in the preliminary stage.However,the regulation of ferroptosis by exosomes is expected to become one of the new potential targets for clinical treatment of various diseases in the future.