Shao Xue, Chen Jiang-Hua
Kidney Disease Center, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2014 Nov;43(6):717-27. doi: 10.3785/j.issn.1008-9292.2014.11.013.
Paraquat (PQ) is a highly effective herbicide with contact toxicity. PQ mainly accumulates in the lungs after absorption into the blood circulation. The respiratory function failure caused by PQ-induced lung injury, especially the irreversible pulmonary fibrosis in late phase, is the leading cause of death in patients with PQ poisoning. The mechanism of PQ poisoning is still unclear. Now it is speculated that oxidative stress and inflammation injury are the main pathogenic mechanisms, and abnormal gene expression, mitochondrial damage, loss of pulmonary surfactant, cytokine network and unbalanced matrix metalloproteinases/tissue inhibitors may be also involved in the pathogenesis. In addition to reducing poison absorption and increasing its removal, the current clinical treatment is mainly composed of antioxidant and anti-immune response, but has poor therapeutic effects. Although many novel methods of treatment have been proposed, most of them are still in the experimental stage. It is a hot spot to clarify the mechanism of PQ poisoning and to seek safe and effective treatment of pulmonary fibrosis. This article reviews the research progress on pathogenesis and treatment of PQ-induced pulmonary fibrosis.
百草枯(PQ)是一种具有接触毒性的高效除草剂。PQ吸收进入血液循环后主要蓄积于肺。PQ所致肺损伤引起的呼吸功能衰竭,尤其是晚期不可逆的肺纤维化,是PQ中毒患者的主要死亡原因。PQ中毒机制尚不清楚。目前推测氧化应激和炎症损伤是主要致病机制,异常基因表达、线粒体损伤、肺表面活性物质丧失、细胞因子网络及基质金属蛋白酶/组织抑制剂失衡等也可能参与发病过程。除减少毒物吸收和增加其清除外,目前临床治疗主要为抗氧化及抗免疫反应,但疗效欠佳。虽然已提出许多新的治疗方法,但大多仍处于实验阶段。阐明PQ中毒机制并寻求安全有效的肺纤维化治疗方法是研究热点。本文综述PQ所致肺纤维化发病机制及治疗的研究进展。