巨噬细胞的胞葬作用:肥胖相关代谢性疾病治疗的新靶向

Macrophage efferocytosis:a new target for the treatment of obesity-related metabolic diseases

背景:巨噬细胞胞葬作用障碍引起的局部和系统炎症损害与多种肥胖相关代谢性疾病有关,且以胞葬作用为靶向的化合物表现出良好的治疗效果。目的:通过综述肥胖对巨噬细胞胞葬作用各个阶段的影响结果分析肥胖抑制胞葬作用的关键机制,总结以胞葬作用为靶向的化合物治疗代谢性疾病的研究现状,以进一步阐明胞葬作用及其与肥胖相关代谢性疾病的关系,为疾病防治策略提供新思路。方法:以“efferocytosis,metabolism,obesity,obese,atherosclerosis,non-alcoholic steatohepatitis,neurodegeneration,tumor,osteoarthritis,diabetes,compound,medicine,treatment”为英文检索词在PubMed和Web of Science数据库检索英文文献,以“胞葬作用”为中文检索词,在中国知网、万方和维普数据库检索中文文献。经严格筛选最终纳入99篇文献进入综述分析。结果与结论:①参与巨噬细胞胞葬作用“寻我”“食我”过程的因子中含有大量凋亡细胞源性因子,因此“寻我”“食我”过程主要受凋亡细胞调控;参与骨架重组和消化过程的胞葬因子主要来源于巨噬细胞,对巨噬细胞胞葬作用活性具有决定性作用。此结果提示,“寻我”“食我”过程的因子表达水平主要反映细胞凋亡情况,在评价巨噬细胞胞葬作用活性时,选择骨架重组和消化阶段的胞葬因子的表达更具科学性。②肥胖抑制巨噬细胞胞葬作用,但肥胖对多数“寻我”“食我”因子及骨架重组因子具有应激性激活作用,对多数消化因子具有抑制作用。此结果进一步说明,消化阶段对胞葬作用活性的决定性意义,并提示部分研究以“寻我”“食我”胞葬因子表达增加作为胞葬作用增强的依据不可靠;且提示未来在探讨以巨噬细胞胞葬作用为靶向的干预策略时,靶向消化阶段胞葬因子可能更有效。③巨噬细胞胞葬作用激活物对多种代谢性疾病治疗有效,但肿瘤组织巨噬细胞胞葬作用抑制物表现出良好的抗癌效果,说明应根据组织炎症特点合理评价胞葬作用的意义。④胞葬作用是2003年提出的一个较新概念,研究历程较短,胞葬因子复杂,目前关于肥胖对胞葬作用影响的研究仅涉及冰山一角并且大部分处于粗浅水平,对其更深入的机制探讨仍需大量科学实验的进一步验证。

BACKGROUND:Dysfunction of macrophage efferocytosis can induce local and systemic inflammatory damage and is associated with a variety of obesity-related metabolic diseases.Moreover,compounds targeting efferocytosis have shown good therapeutic effects.OBJECTIVE:By reviewing the effects of obesity on macrophage efferocytosis,to analyze the key mechanism by which obesity inhibits efferocytosis,to summarize the research progress in compounds targeting efferocytosis to treat obesity-related metabolic diseases,so as to provide new ideas for fully understanding efferocytosis and its relationship with metabolic diseases,aiming to provide new strategies for disease prevention and treatment.METHODS:The English search terms were“efferocytosis,metabolism,obesity,obese,atherosclerosis,non-alcoholic steatohepatitis,neurodegeneration,tumor,osteoarthritis,diabetes,compound,medicine,treatment,”which were used for literature retrieval in PubMed and Web of Science.The Chinese search term was“efferocytosis,”which was used for literature retrieval in CNKI,VIP and WanFang datebases.Ninety-nine papers were finally included in the review analysis after a rigorous screening process.RESULTS AND CONCLUSION:In the process of efferocytosis,the“Find me”and“Eat me”processes involving a large number of apoptotic cell derived factors are mainly regulated by apoptotic cells.The efferocytosis factor involved in cytoskeletal remodeling and digestion are mainly derived from macrophages,which are crucial for efferocytosis activity.These results suggest that the“Find me”and“Eat me”factors mainly reflect the condition of apoptosis,and it is more scientific to select the expression of factors involved in cytoskeletal remodeling and digestion when evaluating the efferocytosis activity of macrophages.Obesity inhibits efferocytosis,and shows an inhibitory effect on most digestive factors,but has a stress-induced activation effect on most“Find me,”“Eat me”and cytoskeletal recombination factors,which further indicates the decisive effect of digestive stage on efferocytosis and suggests that it is not reliable for some studies to evaluate the efferocytosis based on the increased expression of“Find me”and“Eat me”factors.Targeting cytokines in the digestive phase may be more effective when discussing future intervention strategies targeting macrophages efferocytosis.The efferocytosis activators of macrophages are effective in the treatment of various metabolic diseases,but the efferocytosis inhibitors in tumor tissue show good anticancer effects,suggesting that the role of efferocytosis should be rationally evaluated according to the characteristics of tissue inflammation.Efferocytosis is a relatively new concept proposed in 2003,with a short research history and complex efferocytosis factors.Current studies on obesity and efferocytosis only involve a tip of the iceberg and most of them are at a superficial level and a large number of scientific experiments are needed to further validate the mechanisms.