炎性细胞与动脉性肺动脉高压血管重塑

Inflammatory cells and vascular remodeling in pulmonary arterial hypertension

动脉性肺动脉高压(pulmonary arterial hypertension,PAH)是一类严重的渐进性肺血管疾病,主要特征为肺小动脉病变引起的肺血管阻力持续性增加以及肺动脉压进行性升高,进而导致右心衰竭甚至死亡。肺血管重塑是PAH的特征性病理改变,其发生机制涉及基因易感性、血管活性分子失衡、离子通道及信号通路异常等多种因素;近年研究发现,炎性反应在肺血管重塑机制中起着关键作用。在PAH患者和动物模型的肺血管周围发现有大量炎性细胞浸润;此外,在外周血中还检测到显著升高的细胞因子及自身抗体等,并且这些与PAH的不良预后密切相关。本文将对炎性细胞在PAH血管重塑发生中作用的研究进展进行综述,为开发安全有效的PAH治疗方法提供新思路。

Pulmonary arterial hypertension(PAH)is a severe and progressive pulmonary vascular disease mainly characterized by a continuous increase in pulmonary vascular resistance and rise of pulmonary artery pressure caused by pulmonary arteriolar lesions,ultimately resulting in right heart failure and even death.Pulmonary vascular remodeling is a characteristic pathological change of PAH,and its mechanism involves gene susceptibility,imbalance of vasoactive substances,abnormal energy metabolism and other potential factors.Recent studies have found that inflammatory reaction plays a crucial role in the mechanism of pulmonary vascular remodeling.Inflammatory cells are found to infiltrate and accumulate around the pulmonary vessels of PAH patients and of animal models.In addition,significantly high level of cytokines and auto-antibodies were also found in peripheral blood,which is closely related to poor prognosis of PAH.This article reviews the research progress about the potential role of inflammatory cells in the vascular remodeling of PAH and provides new ideas for developing of safe and effective treatment methods for PAH.