中药调控类风湿关节炎中巨噬细胞极化、焦亡、糖代谢的研究进展

Research Progress of Traditional Chinese Medicine in Regulating Macrophage Polarization, Pyroptosis and Glucose Metabolism in Rheumatoid Arthritis

类风湿关节炎骨质发生不可逆性损坏是免疫细胞浸润与成纤维样滑膜细胞增殖的结果,其主要病理特征为滑膜炎与血管翳生成。巨噬细胞作为人体免疫细胞,在类风湿性关节炎中起着重要作用。一方面,免疫稳态的破坏直接诱发全身炎症,巨噬细胞通过与成纤维细胞样滑膜细胞的相互作用引发并延续滑膜炎和组织损伤;另一方面,巨噬细胞的极化在类风湿关节炎发展过程中起着促炎及抗炎双重作用。在疾病进展中,巨噬细胞的极化、焦亡、糖代谢等功能与炎症小体,信号通路等因素联系发生改变,产生促炎因子,进而引起骨破坏及关节障碍,本文就巨噬细胞极化、焦亡、糖代谢与类风湿关节炎的关系进行综述,为类风湿关节炎的治疗提供参考。Irreversible bone damage in rheumatoid arthritis is the result of immune cell infiltration and fibroblast-like synovial cell proliferation. The main pathological features are synovitis and pannus formation. Macrophages, as human immune cells, play an important role in rheumatoid arthritis. On the one hand, the destruction of immune homeostasis directly induces systemic inflammation, and macrophages trigger and continue synovitis and tissue damage through interaction with fibroblast-like synovial cells. On the other hand, the polarization of macrophages plays a dual role of pro-inflammatory and anti-inflammatory in the development of rheumatoid arthritis. In the progression of the disease, the functions of macrophages such as polarization, pyroptosis, and glucose metabolism are changed in connection with factors such as inflammasomes and signaling pathways, resulting in pro-inflammatory factors, which in turn cause bone destruction and joint disorders. This article reviews the relationship between macrophage polarization, pyroptosis, glucose metabolism and rheumatoid arthritis, and provides a reference for the treatment of rheumatoid arthritis.