肾上腺素能促炎通路.doc

儿茶酚胺与炎症的研究进展 青年委员会2009年年会论文投稿麻醉临床与基础研究(autonomic nervous system,ANS)在炎症过程中通过交感神经和副交感神经通路与免疫系统相互作用。ANS在神经-内分泌-免疫调节网络中的作用举足轻重。最近的研究已经证实，迷走神经的输出信号，通过吞噬细胞的胆碱能受体发挥重要的炎症调控作用。该“胆碱能抗炎通路”(cholinergic antiinflammatory pathway,CAP)可以使吞噬细胞失活，抑制细胞因子释放，对于控制全身及局部的炎症有重要意义。肾上腺素能系统与免疫系统的相互作用可能和副交感神经系统正相反，与CAP相抗衡。不同来源的儿茶酚胺(catecholamines，CAs)通过神经-体液机制或自分泌/旁分泌的方式作用于肾上腺素能受体(adrenergic receptors，Development of research on catecholamines and inflammatory LIU- Nian,XU Jun-mei (Department of Anesthesiology Second Xiangya Hospital,Central South University,Changsha ,Hunan 410011,P.R.China) Abstract It is becoming increasingly clear that the autonomic nervous system and the immune system demonstrate cross-talk during inflammation by means of sympathetic and parasympathetic pathways.One of the key pathways involved in the neuroendocrine–immune modulating network is the autonomic nervous system. Recently, vagal parasympathetic signalling has been shown to have an important regulatory function in inflammation through cholinergic receptors on phagocytic cells . Cholinergic anti-inflammatory pathway leading to cellular deactivation and inhibition of cytokine release, plays a critical role in controlling the systemic and local inflammations.Functional interplay of the adrenergic nervous system with the immune/inflammatory system may counterbalance effects of the parasympathetic nervous system.Various sources of catecholamines by means of neural ,humoral or an autocrine/paracrine way can exert pro-inflammatory effects through adrenergic receptors on phagocytic cells during inflammation .We can call it adrenergic pro-inflammatory pathway. Key words adrenergic pro-inflammatory pathway; catecholamines;cytokines; inflammatory 感染、创伤等外界刺激会引起机体免疫细胞释放致炎因子并导致炎症反应。适当的免疫与炎症反应是维持健康所必需的，但炎症反应不足或过强/不当都会对人体造成危害。事实上，人体的许多疾病的真正的罪魁正是机体自身对一些轻微的损害或病原体的不适当的炎症或免疫反应的结果。一方面，缺乏足够的炎症反应的免疫缺陷，导致感染和癌症的发生率增加。另一方面，炎性介质过度释放导致全身性炎症反应，伴随发生严重并发症，可造成全身炎症反应综合征(systemic inflammatory