脂肪源性细胞外囊泡在糖尿病心脏缺血-再灌注损伤中的调控作用

Adipose-derived extracellular vesicles regulation in diabetic heart ischemia-reperfusion injury

缺血性心脏病是糖尿病患者的主要致死原因。尽管血管重建和溶栓治疗能够恢复心肌血流,但糖尿病患者的心功能恢复通常较差、病死率也较高。在这种背景下,心肌缺血-再灌注(ischemia/reperfusion,I/R)损伤成为治疗的主要挑战。研究表明,在糖尿病或肥胖状态下,脂肪细胞会分泌含有RNA、蛋白质、脂肪细胞因子以及线粒体等多种生物分子的细胞外囊泡(extracellular vesicle,EV),此类EV对维持全身代谢稳态极为重要。脂肪细胞来源的EV能与糖尿病心脏进行交流,调控心脏I/R损伤。文章就近年来脂肪细胞来源的EV对糖尿病心脏I/R损伤的调控作用以及潜在机制的相关研究作一综述。

Ischemic heart disease stands as the primary cause of mortality among diabetic patients.Despite advancements in vascular reconstruction and thrombolytic therapy that restore myocardial blood flow,these patients often experience poor cardiac function recovery and a higher mortality rate.This makes myocardial ischemia/reperfusion(I/R)injury a significant therapeutic challenge.Researches indicate that,under diabetic or obese conditions,adipocytes release extracellular vesicles(EVs)containing a variety of biomolecules,including RNA,proteins,adipocytokines,and mitochondria.These EVs play a pivotal role in maintaining systemic metabolic homeostasis.Importantly,adipocyte-derived EVs facilitate communication with diabetic hearts and play a regulatory role in myocardial I/R injury.This review summarizes recent studies on the modulatory effects of adipocyte-derived EVs on diabetic myocardial I/R injury,highlighting potential underlying mechanisms.