心肌梗死后伤口愈合过程中心脏CD68+和稳定素-1+巨噬细胞:从实验到临床

Cardiac CD68+ and stabilin-1+ macrophages in wound healing following myocardial infarction: From experiment to clinic.

作者信息

Ryabov Vyacheslav, Gombozhapova Aleksandra, Rogovskaya Yuliya, Kzhyshkowska Julia, Rebenkova Mariya, Karpov Rostislav

机构信息

Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, 111a Kievskaya Street, Tomsk, 634012, Russian Federation; National Research Tomsk State University, 36 Lenin Avenue, Tomsk, 634050, Russian Federation; Siberian State Medical University, 2 Moskovsky Trakt, Tomsk, 634055, Russian Federation.

Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, 111a Kievskaya Street, Tomsk, 634012, Russian Federation; National Research Tomsk State University, 36 Lenin Avenue, Tomsk, 634050, Russian Federation.

出版信息

Immunobiology. 2018 Apr-May;223(4-5):413-421. doi: 10.1016/j.imbio.2017.11.006. Epub 2017 Nov 22.

Abstract

Myocardial infarction (MI) remains the leading cause of mortality and morbidity throughout the world. Macrophages are key innate immune cells that play a significant role in transition from the inflammatory to the regenerative phase during wound healing following MI. The scavenger receptor stabilin-1 is one of the most interesting macrophage biomarkers. This receptor contributes to wound healing, angiogenesis, and tissue remodeling. We suggested a research protocol using macrophage biomarkers to study the cellular basis of cardiac remodeling and healing in patients with acute MI. The purpose of the research was to translate experimental knowledge regarding macrophage subsets and their biomarkers in post-infarction myocardial regeneration into results observed in clinical settings. The study included 41 patients with fatal MI type 1. All patients were divided into four groups according to the timeline of MI histopathology. In addition to routine histopathological analysis, macrophage infiltration was assessed by immunohistochemistry. We used CD68 as a marker for the cells of the macrophage lineage and stabilin-1 as an M2-like macrophage biomarker. The number of CD68+ and stabilin-1+ macrophages in the infarct area increased and peaked in the regenerative phase and did not decrease in the late stage of MI. In the peri-infarct area, the number of CD68+ macrophages increased in the inflammatory phase, peaked during the reparative phase, and did not decrease in the late phase, while the number of stabilin-1+ macrophages increased in the regenerative phase and remained unchanged. Additionally, in the reparative phase, we observed increase in the number of CD68+ and stabilin-1+ macrophages in the non-infarct area. The research protocol suggested allowed us to translate experimental knowledge regarding macrophage subsets and their biomarkers in post-infarction myocardial regeneration into clinical data. Taken together, these results demonstrated biphasic cardiac macrophage response following acute MI somewhat similar to that in a murine model. The increase in stabilin-1+ macrophage infiltration noticed in the myocardium during the regenerative phase and the strong positive correlation between the number of these cells and timeline of MI histopathology enabled us to propose stabilin-1 as a diagnostic macrophage biomarker in myocardium wound healing in patients with acute MI.

摘要

心肌梗死(MI)仍然是全球范围内导致死亡和发病的主要原因。巨噬细胞是关键的固有免疫细胞,在心肌梗死后伤口愈合过程中从炎症阶段过渡到再生阶段发挥着重要作用。清道夫受体稳定素-1是最引人关注的巨噬细胞生物标志物之一。该受体有助于伤口愈合、血管生成和组织重塑。我们提出了一项研究方案,利用巨噬细胞生物标志物来研究急性心肌梗死患者心脏重塑和愈合的细胞基础。该研究的目的是将关于巨噬细胞亚群及其生物标志物在梗死心肌再生中的实验知识转化为临床观察结果。该研究纳入了41例1型致命性心肌梗死患者。所有患者根据心肌梗死组织病理学的时间线分为四组。除了常规组织病理学分析外,还通过免疫组织化学评估巨噬细胞浸润情况。我们使用CD68作为巨噬细胞谱系细胞的标志物,使用稳定素-1作为M2样巨噬细胞生物标志物。梗死区域CD68+和稳定素-1+巨噬细胞的数量增加,并在再生阶段达到峰值,在心肌梗死后期并未减少。在梗死周边区域,CD68+巨噬细胞的数量在炎症阶段增加,在修复阶段达到峰值,在后期并未减少,而稳定素-1+巨噬细胞的数量在再生阶段增加并保持不变。此外,在修复阶段,我们观察到非梗死区域CD68+和稳定素-1+巨噬细胞的数量增加。所提出的研究方案使我们能够将关于巨噬细胞亚群及其生物标志物在梗死心肌再生中的实验知识转化为临床数据。综上所述,这些结果表明急性心肌梗死后心脏巨噬细胞呈现双相反应,这在某种程度上与小鼠模型相似。在再生阶段心肌中观察到稳定素-1+巨噬细胞浸润增加,且这些细胞数量与心肌梗死组织病理学时间线之间存在强正相关,这使我们能够提出稳定素-1作为急性心肌梗死患者心肌伤口愈合的诊断性巨噬细胞生物标志物。

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