铜过载介导心肌缺血再灌注损伤的作用及机制研究进展

Research progress on the effect and mechanism of copper overload in myocardial ischemia-reperfusion injury

急性心肌梗死(acute myocardial infarction,AMI)的发病率逐年上升,尽管临床上治疗方法不断增加,但大量患者冠脉再通后会出现心肌缺血再灌注损伤(myocardial ischemia-reperfusion injury,MIRI),使心肌损伤进一步加重,进而发生心肌机械性破坏、心力衰竭及恶性心律失常等心血管不良事件,导致患者生活质量下降及经济负担增加。铜作为人体中一种重要微量元素,其稳态与MIRI的发生、发展密切相关。当铜稳态失衡时,细胞内过量的铜通过氧化应激、炎症反应及铜死亡等一系列途径,加重MIRI。本文综述机体铜水平与MIRI的关系,深入探讨铜过载加重MIRI机制,有助于更全面了解铜过载在MIRI发生、发展中的作用,以期为MIRI提供新的治疗靶点。

The incidence of acute myocardial infarction(AMI)is increasing year by year.Despite the increasing clinical treatment methods,myocardial ischemia-reperfusion injury(MIRI)occurs in a large number of patients after coronary recanalization,which further aggravates myocardial injury and leads to cardiovascular adverse events such as myocardial mechanical destruction,heart failure and malignant arrhythmia,resulting in decreased quality of life and increased socioeconomic burden.As an important trace element in the human body,copper homeostasis is closely related to the occurrence and development of MIRI.When copper homeostasis is imbalanced,the excess copper in the cells aggravates MIRI through a series of pathways such as oxidative stress,inflammatory reaction and cuproptosis.This article reviews the relationship between copper level and MIRI,and deeply discusses the mechanism of copper overload aggravating MIRI,which will help to more comprehensively understand the role of copper overload in the occurrence and development of MIRI in order to offer new therapeutic targets for MIRI.