中性粒细胞胞外诱捕网在肝脏缺血再灌注损伤中的研究进展

Research progress of NETs in hepatic ischemia-reperfusion injury

目的 总结中性粒细胞胞外诱捕网(neutrophil extracellular traps,NETs)在肝脏缺血-再灌注损伤(hepatic ischemia-reperfusion injury, HIRI)中的作用机制及靶向NETs减轻HIRI的研究进展,为减轻HIRI提供有价值的参考依据。方法 检索国内外有关NETs在HIRI发生机制中的作用及靶向NETs减轻HIRI的相关文献予以综述。结果 HIRI通常出现在肝脏手术过程中,是一种常见的临床问题,发生在肝脏手术、器官移植、肝缺血等情况下。这种损伤会导致组织坏死、炎症反应和氧化应激,是肝脏术后肝功能障碍和多器官功能衰竭的一个主要原因,在很大程度上增加了肝脏术后的并发症和死亡率。NETs在肝脏缺血-再灌注诱导的无菌性炎症反应中起着至关重要的作用。在肝脏缺血-再灌注时,中性粒细胞通过形成NETs促进炎症级联反应和细胞因子风暴,加重肝脏缺血-再灌注引起的损伤,目前已经有一些实验和临床研究表明,通过抑制NETs形成或清除已形成的NETs可以减轻HIRI并改善预后。结论 靶向NETs可能成为治疗HIRI的一种新方法。在未来可预见将会有更多关于靶向NETs治疗HIRI方面的实验和临床试验的开展;并逐渐建立起更完善、更有效的治疗策略,从而为临床上改善肝脏术后患者预后提供新途径。

Objective To summarize the mechanism of neutrophil extracellular traps(NETs)in hepatic ischemia-reperfusion injury(HIRI)and the research progress in targeting NETs to reduce HIRI,providing valuable reference for reducing HIRI.Method The related literatures at home and abroad about the role of NETs in the pathogenesis of HIRI and target NETs to alleviate HIRI were retrieved and reviewed.Results HIRI usually appeared in the process of liver surgery and was a common clinical problem,which occured in situations such as liver surgery,organ transplantation,liver ischemia and so on.This kind of injury would lead to tissue necrosis,inflammatory response and oxidative stress,which was a major cause of hepatic dysfunction and multiple organ failure after hepatic surgery,greatly increases the complications and mortality after hepatic surgery.NETs played a crucial role in the aseptic inflammatory response induced by hepatic ischemia/reperfusion.During hepatic ischemia-reperfusion,neutrophils promoted inflammatory cascade reactions and cytokine storms by forming NETs,exacerbating damage caused by hepatic ischemiareperfusion.At present,some experimental and clinical studies had shown that inhibiting the formation of NETs or eliminating the formed NETs could alleviate the hepatic ischemia-reperfusion injury and improve the prognosis.Conclusions Targeting NETs may become a new method for treating hepatic ischemia-reperfusion injury.In the future,it is foreseeable that more experiments and clinical trials will be conducted on targeted NETs for the treatment of hepatic ischemia-reperfusion injury.And gradually establish more comprehensive and effective treatment strategies,thereby providing new ways to improve the prognosis of hepatic surgery patients in clinical practice.