斑块侵蚀在急性冠状动脉综合征中的作用及机制研究进展

Research progress on the role and mechanism of plaque erosion in acute coronary syndrome

急性冠状动脉综合征是世界范围内发病率和死亡率较高的一组临床综合征。目前,越来越多的证据表明,带有完整纤维帽的斑块侵蚀是导致急性冠状动脉综合征的主要原因之一。基础实验已经揭示了斑块侵蚀的独特分子特征,已有研究表明,血流紊乱会引起内皮细胞损伤,从而导致基底膜丧失其完整性以及内皮细胞脱落,继而形成中性粒细胞胞外陷阱和血栓,导致斑块侵蚀。文章将讨论动脉粥样硬化斑块侵蚀的分子特征以及对斑块侵蚀患者未来精准医疗所需的转化研究。

Acute coronary syndrome(ACS) is a group of clinical syndromes with high morbidity and mortality worldwide. Increasing evidence suggest that plaque erosion with an intact fibrous cap is one of the major causes responsible for ACS. Basic experiments have shed light on the unique molecular characteristics of plaque erosion. It has been indicated that plaque erosion starts with the changes of blood flow disturbance-induced endothelial cell damage, resulting in loss of basement membrane integrity and endothelial cell desquamation, with consequent formation of neutrophil extracellular traps and thrombosis. This review will discuss the molecular characteristics of atherosclerotic plaque erosion and translational research needed for future precision medicine in patients with plaque erosion.