

浏览全部资源
扫码关注微信
湖南中医药大学 中医学院,长沙 410208
Received:07 May 2021,
Published Online:03 August 2021,
Published:05 March 2022
移动端阅览
杨梦,李琳,梁昊等.基于阴阳学说探讨巨噬细胞极化在心力衰竭炎症中的作用[J].中国实验方剂学杂志,2022,28(05):219-226.
YANG Meng,LI Lin,LIANG Hao,et al.Discussion on Role of Macrophage Polarization in Inflammation of Heart Failure Based on Yin-yang Theory[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(05):219-226.
杨梦,李琳,梁昊等.基于阴阳学说探讨巨噬细胞极化在心力衰竭炎症中的作用[J].中国实验方剂学杂志,2022,28(05):219-226. DOI: 10.13422/j.cnki.syfjx.20211850.
YANG Meng,LI Lin,LIANG Hao,et al.Discussion on Role of Macrophage Polarization in Inflammation of Heart Failure Based on Yin-yang Theory[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(05):219-226. DOI: 10.13422/j.cnki.syfjx.20211850.
炎症是心力衰竭(以下简称“心衰”)的关键致病特征,其过表达可致心肌肥大、凋亡及纤维化,加重心衰的进程。巨噬细胞是人体重要的免疫细胞,具有高度异质性,参与炎症反应及维持心脏稳态。巨噬细胞极化是一个动态过程,在不同微环境的刺激下,巨噬细胞可极化2个亚群:经典激活的M1型和替代激活的M2型,两者相互拮抗。当巨噬细胞极化为促炎表型M1为主时,启动炎症反应;以抗炎表型M2为主时,发挥抑制心衰炎症、修复组织作用。同时,在心衰发展的不同阶段,M1和M2之间可相互转化,这与中医学说的阴阳制约、平衡和转化内涵相似。基于此,笔者拟通过阴阳理论来阐明M1与M2型巨噬细胞之间的关系,提出临床防治心衰应重视微观和宏观的炎症反应,调控巨噬细胞极化,使“抗炎”和“促炎”达到平衡,这与中医理论中调节机体阴阳平衡相一致,可为心衰的中医药治疗提供新靶点和新方向。
Inflammation is the key pathogenic feature of heart failure (HF), and its overexpression can cause myocardial hypertrophy, apoptosis and fibrosis, aggravating the process of HF. Macrophages are important immune cells in human body with high heterogeneity, which involve in inflammation response and maintain heart homeostasis. Macrophage polarization is a dynamic process. Under the stimulation of different microenvironment, it can polarize two subsets, including classically activated M1 type and alternatively activated M2 type, which are antagonistic to each other. When macrophages polarize into the pro-inflammatory phenotype (M1), the inflammatory response is initiated, the anti-inflammatory phenotype (M2) plays a role in inhibiting inflammation and repairing tissue. At the same time, in different stages of development of HF, M1 and M2 macrophages can be transformed into each other, which is similar to the connotation of Yin-yang restriction, balance and transformation of traditional Chinese medicine (TCM) theory. Based on this, this paper intends to clarify the relationship between M1 and M2 macrophages by Yin-yang theory, proposing that the clinical prevention and treatment of HF should pay attention to regulating micro and macro inflammatory responses, regulating macrophage polarization, and achieving the balance between anti-inflammatory and pro-inflammation, which is consistent with the balance of Yin-yang in TCM theory. It can provide a new target and direction for TCM treatment of HF.
GLASENAPP A , DERLIN K , WANG Y , et al . Multimodality imaging of inflammation and ventricular remodeling in pressure-overload heart failure [J]. J Nucl Med , 2020 , 61 ( 4 ): 590 - 596 .
BUI A L , HORWICH T B , FONAROW G C . Epidemiology and risk profile of heart failure [J]. Nat Rev Cardiol , 2011 , 8 ( 1 ): 30 - 41 .
LAVINE K J , PINTO A R , EPELMAN S , et al . The macrophage in cardiac homeostasis and disease:JACC macrophage in CVD series (part 4) [J]. J Am Coll Cardiol , 2018 , 72 ( 18 ): 2213 - 2230 .
LI L , ZHONG S , CHENG B , et al . Cross-talk between gut microbiota and the heart:a new target for the herbal medicine treatment of heart failure? [J]. Evid Based Complement Alternat Med , 2020 , 2020 : 9097821 .
SAVARESE G , LUND L H . Global public health burden of heart failure [J]. Card Fail Rev , 2017 , 3 ( 1 ): 7 - 11 .
BRENES-CASTRO D , CASTILLO E C , VÁZQUEZ-GARZA E , et al . Temporal frame of immune cell infiltration during heart failure establishment:lessons from animal models [J]. Int J Mol Sci , 2018 , 19 ( 12 ): 3719 .
MANN D L . Innate immunity and the failing heart:the cytokine hypothesis revisited [J]. Circ Res , 2015 , 116 ( 7 ): 1254 - 1268 .
SHAHID F , LIP G Y H , SHANTSILA E . Role of monocytes in heart failure and atrial fibrillation [J]. J Am Heart Assoc , 2018 , 7 ( 3 ): e007849
ABERNTHY A , RAZA S , SUN J L , et al . Pro-inflammatory biomarkers in stable versus acutely decompensated heart failure with preserved ejection fraction [J]. J Am Heart Assoc , 2018 , 7 ( 8 ): e007385 .
DUNCAN S E , GAO S , SARHENE M , et al . Macrophage activities in myocardial infarction and heart failure [J]. Cardiol Res Pract , 2020 , 2020 : 4375127 .
SICA A , MANTOVANI A . Macrophage plasticity and polarization: in vivo veritas [J]. J Clin Invest , 2012 , 122 ( 3 ): 787 - 795 .
WANG N , LIANG H , ZEN K . Molecular mechanisms that influence the macrophage M1-M2 polarization balance [J]. Front Immunol , 2014 , 5 : 614 .
BROWN B N , RATNER B D , GOODMAN S B , et al . Macrophage polarization:an opportunity for improved outcomes in biomaterials and regenerative medicine [J]. Biomaterials , 2012 , 33 ( 15 ): 3792 - 3802 .
OʹROURKE S A , DUNNE A , MONAGHAN M G . The role of macrophages in the infarcted myocardium:Orchestrators of ECM remodeling [J]. Front Cardiovasc Med , 2019 , 6 : 101 .
ZHANG Y H , HE M , WANG Y , et al . Modulators of the balance between M1 and M2 macrophages during pregnancy [J]. Front Immunol , 2017 , 8 : 120 .
WANG Y , HAN C C , CUI D Q , et al . Is macrophage polarization important in rheumatoid arthritis? [J]. Int Immunopharmacol , 2017 , 50 : 345 - 352 .
VAN DER LAAN A M , TER HORST E N , DELEWI R , et al . Monocyte subset accumulation in the human heart following acute myocardial infarction and the role of the spleen as monocyte reservoir [J]. Eur Heart J , 2014 , 35 ( 6 ): 376 - 385 .
李俊杰 , 李亚玲 , 刘永琦 , 等 . M1/M2型肺泡巨噬细胞亚群在新型冠状病毒肺炎中的作用及中医药调控机制研究进展 [J]. 中国实验方剂学杂志 , 2020 , 26 ( 19 ): 99 - 107 .
BACI D , BOSI A , PARISI L , et al . Innate immunity effector cells as inflammatory drivers of cardiac fibrosis [J]. Int J Mol Sci , 2020 , 21 ( 19 ): 7165 .
何莲花 , 覃清霞 , 王晗 , 等 . 二妙散对大鼠骨髓来源的巨噬细胞M1/M2极化的影响 [J]. 中国实验方剂学杂志 , 2020 , 26 ( 11 ): 71 - 77 .
FRANGOGIANNIS N G . Inflammation in cardiac injury,repair and regeneration [J]. Curr Opin Cardiol , 2015 , 30 ( 3 ): 240 - 245 .
BEN-MORDECHAI T , PALEVSKI D , GLUCKSAM-GALNO Y Y , et al . Targeting macrophage subsets for infarct repair [J]. J Cardiovasc Pharmacol Ther , 2015 , 20 ( 1 ): 36 - 51 .
OLEFSKY J M , GLASS C K . Macrophages,inflammation,and insulin resistance [J]. Annu Rev Physiol , 2010 , 72 : 219 - 246 .
XU H X , ZHU J , SMITH S , et al . Notch-RBP-J signaling regulates the transcription factor IRF8 to promote inflammatory macrophage polarization [J]. Nat Immunol , 2012 , 13 ( 7 ): 642 - 650 .
LIN Y , ZHAO J L , ZHENG Q J , et al . Notch signaling modulates macrophage polarization and phagocytosis through direct suppression of signal regulatory protein α expression [J]. Front Immunol , 2018 , 9 : 1744 .
HUANG F , ZHAO J L , WANG L , et al . miR-148a-3p mediates Notch signaling to promote the differentiation and M1 activation of macrophages [J]. Front Immunol , 2017 , 8 : 1327 .
WEI W , LI Z P , BIAN Z X , et al . Astragalus polysaccharide RAP induces macrophage phenotype polarization to M1 via the Notch signaling pathway [J]. Molecules , 2019 , 24 ( 10 ): 2016 .
阮静瑶 , 陈必成 , 张喜乐 , 等 . 巨噬细胞M1/M2极化的信号通路研究进展 [J]. 免疫学杂志 , 2015 , 31 ( 10 ): 911 - 917 .
HAWIGER J . Innate immunity and inflammation:a transcriptional paradigm [J]. Immunol Res , 2001 , 23 ( 2/3 ): 99 - 109 .
GONG M , ZHUO X Z , MA A Q . STAT6 upregulation promotes M2 macrophage polarization to suppress atherosclerosis [J]. Med Sci Monit Basic Res , 2017 , 23 : 240 - 249 .
DATE D , DAS R , NARLA G , et al . Kruppel-like transcription factor 6 regulates inflammatory macrophage polarization [J]. J Biol Chem , 2014 , 289 ( 15 ): 10318 - 10329 .
HULSMANS M , SAGER H B , ROH J D , et al . Cardiac macrophages promote diastolic dysfunction [J]. J Exp Med , 2018 , 215 ( 2 ): 423 - 440 .
TPRRE-AMIONE G . Immune activation in chronic heart failure [J]. Am J Cardiol , 2005 , 95 ( 11A ): 3 C-8C,38C-40C.
APOSTLAKIS S , LIP G Y H , SHANTSILA E . Monocytes in heart failure:relationship to a deteriorating immune overreaction or a desperate attempt for tissue repair? [J]. Cardiovasc Res , 2010 , 85 ( 4 ): 649 - 660 .
胡丹丽 . 激肽释放酶-1过表达通过选择性调节巨噬细胞的极化延缓心脏衰老 [D]. 武汉 : 华中科技大学 , 2018 .
HALADE G V , NORRIS P C , KAIN V , et al . Splenic leukocytes define the resolution of inflammation in heart failure [J]. Sci Signal , 2018 , 11 ( 520 ): eaao1818 .
LYU J , CHEN J , WANG M J , et al . Klotho alleviates indoxyl sulfate-induced heart failure and kidney damage by promoting M2 macrophage polarization [J]. Aging (Albany NY) , 2020 , 12 ( 10 ): 9139 - 9150 .
DICK S A , EPELMAN S . Chronic heart failure and inflammation:what do we really know? [J]. Circ Res , 2016 , 119 ( 1 ): 159 - 176 .
PRABHU S D , FRANGOGIANNIS N G . The biological basis for cardiac repair after myocardial infarction:from inflammation to fibrosis [J]. Circ Res , 2016 , 119 ( 1 ): 91 - 112 .
HANNA A , FRANGOGIANNIS N G . Inflammatory cytokines and chemokines as therapeutic targets in heart failure [J]. Cardiovasc Drugs Ther , 2020 , 34 ( 6 ): 849 - 863 .
VERJANS R , DERKS W J A , KORN K , et al . Functional screening identifies microRNAs as multi-cellular regulators of heart failure [J]. Sci Rep , 2019 , 9 ( 1 ): 6055 .
STRASSHEIM D , DEMPSEY E C , GERASIMOVSKAYA E , et al . Role of inflammatory cell subtypes in heart failure [J]. J Immunol Res , 2019 , 2019 : 2164017 .
权月 , 田格尔 , 周骏腾 , 等 . 压力超负荷诱导的心肌肥厚/心力衰竭模型鼠肝肾损伤及巨噬细胞活化水平的变化 [J]. 四川大学学报:医学版 , 2020 , 51 ( 3 ): 331 - 336 .
李静 , 梅冬 . 血清巨噬细胞炎性蛋白-2在心力衰竭合并肺部感染诊断中临床价值研究 [J]. 湖南师范大学学报:医学版 , 2016 , 13 ( 5 ): 33 - 36 .
GONZÁLEZ G E , RHALEB N E , DʹAMBROSIO M A , et al . Cardiac-deleterious role of galectin-3 in chronic angiotensin Ⅱ-induced hypertension [J]. Am J Physiol Heart Circ Physiol , 2016 , 311 ( 5 ): H1287 - H1296 .
邹旭 , 吴焕林 , 邓铁涛 . 邓铁涛教授治疗充血性心力衰竭经验选粹 [J]. 中华中医药学刊 , 2004 , 22 ( 4 ): 583 - 590 .
周仲瑛 . 读经典,谈感悟 [J]. 南京中医药大学学报 , 2007 , 23 ( 5 ): 273 - 277 .
毛静远 . 心力衰竭的中医辨证治疗要点 [J]. 中国中西医结合杂志 , 2008 , 28 ( 12 ): 1063 - 1064 .
LU H . p53 and MDM2:their Yin-Yang intimacy [J]. J Mol Cell Biol , 2017 , 9 ( 1 ): 1 - 2 .
PERDIGUERO E G , GEISSMANN F . The development and maintenance of resident macrophages [J]. Nat Immunol , 2016 , 17 ( 1 ): 2 - 8 .
MURRAY P J , ALLEN J E , BISWAS S K , et al . Macrophage activation and polarization:nomenclature and experimental guidelines [J]. Immunity , 2014 , 41 ( 1 ): 14 - 20 .
YUE Y , HUANG S Q , LI H Y , et al . M2b macrophages protect against myocardial remodeling after ischemia/reperfusion injury by regulating kinase activation of platelet-derived growth factor receptor of cardiac fibroblast [J]. Ann Transl Med , 2020 , 8 ( 21 ): 1409 .
ANONYMITY . Essence of harmony [J]. Nat Immunol , 2005 , 6 ( 4 ): 325 .
LU W J , WANG Q Y , SUN X Q , et al . Qishen granule improved cardiac remodeling via balancing M1 and M2 macrophages [J]. Front Pharmacol , 2019 , 10 : 1399 .
曾海燕 , 方勇 , 曾高峰 . 丹红注射液对脂多糖诱导THP-1巨噬细胞促炎因子分泌的影响及机制 [J]. 中南医学科学杂志 , 2014 , 42 ( 5 ): 443 - 446 .
ZHANG X , LIU M H , QIAO L , et al . Ginsenoside Rb 1 enhances atherosclerotic plaque stability by skewing macrophages to the M2 phenotype [J]. J Cell Mol Med , 2018 , 22 ( 1 ): 409 - 416 .
0
Views
30
下载量
7
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution
京公网安备11010802024621