血管外膜在动脉粥样硬化中的作用

动脉粥样硬化被认为是受损的内皮细胞释放粘附因子,吸引单核细胞粘附浸润到内膜下吞噬脂质,同时平滑肌细胞进行增殖迁移并形成新生内膜的过程,但目前越来越多的证据提示血管外膜作为反应的先导者从外向内参与了这一过程。在诸多血管疾病模型中,均能检测到外膜的早期激活。成纤维细胞作为血管外膜的主要细胞成分,在血管损伤早期会进行增殖迁移至中膜和内膜,还可以通过释放活性氧、各种细胞因子、基质金属蛋白酶等来影响炎症反应,导致内膜增生,最终促进了血管重塑及一些心血管疾病的发生。因此,越来越多的研究关注外膜成纤维细胞对于动脉粥样硬化、糖尿病、腹主动脉瘤等疾病中的作用及其机制,本文对该领域新近研究进展做一综述。

The role of adventitia in atherosclerosis

In the past decade, studies of vascular injury and repair have mainly focused on endothelial cells and medial smooth muscle cells. However, increasing evidence supports a new paradigm of an "outside-in" hypothesis, in which vascular adventitia may take part as a precursor in response to injury or vascular inflammation. During early stage of injury, the major cellular component of adventitia-fibroblasts, not only proliferate/migrate to media and intima, but also affect inflammatory response by increased production of reactive oxygen species and release of various proinflammatory cytokines, growth factors, matrix metalloproteinase etc. All of these eventually synergistically initiate neointima formation, followed by subsequent vascular remodeling and cardiovascular diseases. Thus the current review will focus on most advanced studies related to the role of adventitial fibroblasts in some cardiovascular diseases such as atherosclerosis.