肝巨噬细胞及其可塑性特征对治疗慢加急性肝衰竭的潜在价值及研究进展

doi:10.3969/j.issn.1006-5725.2024.14.023

摘要/Abstract

摘要：

慢加急性肝衰竭（ACLF）是在慢性肝病的基础上，由各种急性诱发因素引起的一组与严重急性肝功能损害和多器官衰竭相关的临床综合征。由于病情严重、发展迅速、病死率高，这种征求受到越来越多的关注。近年研究表明，ACLF的发病机制主要包括直接损伤和免疫损伤。作为肝脏中主要的免疫细胞，肝巨噬细胞在ACLF中的免疫调节作用也越来越被认可。肝巨噬细胞群在表观遗传重编程或局部微环境影响下有着出色的表型转换表现及可塑性特征，这种适应表达能力可利用关键介质来促进抗炎表型的早期转换，以缓解肝脏损伤的现象。大量研究表明肝巨噬细胞在逆转ACLF过程中存在一定潜力，故本文从肝巨噬细胞的可塑性特征角度出发，阐述肝巨噬细胞在ACLF中的作用以及干预ACLF疾病进程的研究，综述其在ACLF治疗中的潜在意义。

关键词: 慢加急性肝衰竭, 巨噬细胞, 细胞可塑性, 免疫调节

Abstract:

Acute-on-chronic liver failure （ACLF） is a group of clinical syndromes related to severe acute liver function damage and multiple organ failure caused by various acute inducing factors on the basis of chronic liver disease. Due to its serious condition， rapid progression and high mortality， it has attracted more and more attention. Recent studies have shown that the pathogenesis of ACLF mainly includes direct injury and immune injury. As the main immune cells in the liver， the immunoregulatory role of liver macrophages in ACLF has been increasingly recognized. Liver macrophages have excellent phenotype conversion function and plasticity characteristics under the influence of epigenetic reprogramming or local microenvironment. This adaptive expression ability can use key mediators to promote the early conversion of anti-inflammatory phenotype to alleviate liver injury. A large number of studies have shown that liver macrophages have a certain potential in reversing the process of ACLF. Therefore， from the perspective of the plasticity characteristics of liver macrophages， this paper expounds the role of liver macrophages in ACLF and the research on the intervention of ACLF disease process， and summarizes its potential significance in the treatment of ACLF.

Key words: acute-on-chronic liver failure, macrophage, cell plasticity, immunomodulation

中图分类号:

R575.3

陈桂容,王明刚,林华明,陈鑫鑫,罗娟,叶凤琴,王秀峰. 肝巨噬细胞及其可塑性特征对治疗慢加急性肝衰竭的潜在价值及研究进展[J]. 实用医学杂志, 2024, 40(14): 2035-2040.

Guirong CHEN,Minggang WANG,Huaming LIN,Xinxin CHEN,Juan LUO,Fengqin YE,Xiufeng. WANG. Potential value of liver macrophages and their plasticity in the treatment of ACLF[J]. The Journal of Practical Medicine, 2024, 40(14): 2035-2040.

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