淋巴管生成的调节及其在心肌梗死中的作用研究进展

Research progress on regulation of lymphangiogenesis and its role in myocardial infarction

淋巴管系统调节组织液内稳态、脂质代谢、免疫功能,在体内发挥着重要作用。心肌梗死后,增强淋巴管生成可加快清除浸润的免疫细胞,减少促炎细胞因子的生成,减少水肿、炎症和纤维化,促进受损心脏功能恢复。血管内皮生长因子(vascular endothelial growth factor,VEGF)-C及血管内皮生长因子受体(vascular endothelial growth factor receptor,VEGFR)-3是淋巴管生成通路的组成部分,在心脏损伤后维持组织液平衡和心肌功能方面具有至关重要的作用。淋巴管与免疫系统之间密切相关,不同的免疫细胞群对淋巴重塑产生刺激或抑制作用。巨噬细胞是广泛分布在器官和组织中的先天免疫细胞,在器官发育、宿主防御、急性和慢性炎症、组织稳态和重塑等多种生理和病理过程中发挥着重要作用。还需要确定淋巴管生成的更多机制,为临床刺激淋巴管生成治疗心脏疾病提供有效的靶点。本文综述了心肌梗死后心脏及淋巴管基本的病理变化、淋巴管生成的调控因素以及巨噬细胞对淋巴管生成的影响。

The lymphatic system plays an important role in regulating interstitial fluid homeostasis,lipid metabolism,and immune functions.After myocardial infarction,enhanced lymphangiogenesis accelerates clearance of infiltrating immune cells,reduces production of proinflammatory cytokines,reduces edema,inflammation,and fibrosis,and promotes recovery of impaired heart functions.Vascular endothelial growth factor-C(VEGF-C)and its receptor,VEGFR-3,are components of the lymphangiogenesis pathway and play a critical role in maintaining the tissue fluid balance and myocardial functions after cardiac injury.Lymphatic vessels are closely related to the immune system.Various immune cell populations stimulate or inhibit lymphatic remodeling.Macrophages are congenital immune cells distributed widely in organs and tissues,play an important role in various physiological and pathological processes such as organ development,host defense,acute and chronic inflammation,and tissue homeostasis and remodeling.More mechanisms of lymphangiogenesis need to be clarified to provide effective targets for clinical stimulation of lymphangiogenesis to treat heart disease.This article reviews basic pathological changes of the heart and lymphatic vessels after myocardial infarction,the regulatory factors of lymphangiogenesis,and the influence of macrophages on lymphangiogenesis.