巨噬细胞极化在脊髓损伤后炎症中的作用

Roles of macrophage polarization in inflammation after spinal cord injury

脊髓损伤(spinal cord injury,SCI)是一种严重的致死性的神经系统疾病。由于创伤或非创伤的因素导致脊髓结构与功能的完全或不完全破坏,患者发生永久性的感觉-运动-自主神经功能障碍。除此之外,还可引起顽固的神经病理性疼痛,给患者身心带来了极大的痛苦。脊髓损伤包括原发性损伤和继发性损伤,原发性损伤来自于损伤即刻,具有不可逆性,后续的继发性损伤包括分子和细胞水平的病理变化,其中炎症是继发性损伤的重要机制,可导致组织损伤、血管通透性增加、神经元凋亡、脂质过氧化、组织瘢痕及神经病理性疼痛形成等伤害性结局。而巨噬细胞作为免疫应答的效应细胞,是脊髓损伤后炎症反应的重要参与者,可极化为M1和M2型,发挥不同的作用,因此具有很大的可塑性。大量的研究通过干预巨噬细胞从而达到治疗脊髓损伤的目的。本文主要阐述了不同方法调节巨噬细胞极化在脊髓损伤后炎症反应中的作用。

Spinal cord injury(SCI)is a severe and fatal neurological disorder in which the structure and function of the spinal cord are completely or incompletely destroyed by traumatic or non-traumatic factors,resulting in permanent sensorimotor autonomic dysfunction.In addition,it can also cause stubborn neuropathic pain,which brings great pain to patients physically and mentally.Spinal cord injury includes primary injury and secondary injury.Primary injury comes from immediate injury and is irreversible,while subsequent secondary injury includes pathological changes at molecular and cellular levels,among which inflammation is an important mechanism of secondary injury.It can lead to tissue injury,increased vascular permeability,neuronal apoptosis,lipid peroxidation,tissue scar and neuropathic pain.Macrophages,as effector cells of immune response,are important participants in the inflammatory response after spinal cord injury.They can be polarized into M1 and M2 types and play different roles,so they have great plasticity.A large number of studies have achieved the purpose of treating spinal cord injury by intervening macrophages.The effects of different methods to regulate macrophage polarization on the inflammatory response after spinal cord injury were discussed in this paper.