Mehta J L, Nichols W W, Mehta P
Department of Medicine, University of Florida College of Medicine, Gainesville.
J Am Coll Cardiol. 1988 Jun;11(6):1309-16. doi: 10.1016/0735-1097(88)90297-5.
An interaction among leukocytes, platelets and endothelial cells is important in atherogenesis and in maintenance of blood flow and vascular tone. These complex cell-cell interactions are mediated by release of such metabolic substances as arachidonic acid metabolites, growth factors, oxygen free radicals and endothelium-derived relaxing factor. These substances participate in the regulation of blood flow in health and disease, and perturbation in the delicate equilibrium among various cellular elements may lead to evolution and propagation of myocardial ischemia. During reperfusion of ischemic myocardium, neutrophils together with platelets cause capillary plugging in the coronary microcirculation and exert detrimental effects on endothelial function resulting in the "no reflow" phenomenon, ventricular arrythmias, loss of coronary vascular reserve and, perhaps, extension of cellular injury. This review addresses the mechanisms of cell-cell interactions with special reference to myocardial ischemia and the potential for development of improved therapy to protect and preserve ischemic myocardium.
白细胞、血小板和内皮细胞之间的相互作用在动脉粥样硬化的发生以及维持血流和血管张力方面具有重要意义。这些复杂的细胞间相互作用是由花生四烯酸代谢产物、生长因子、氧自由基和内皮源性舒张因子等代谢物质的释放介导的。这些物质参与健康和疾病状态下血流的调节，各种细胞成分之间微妙平衡的扰动可能导致心肌缺血的进展和扩散。在缺血心肌再灌注期间，中性粒细胞与血小板一起导致冠状动脉微循环中的毛细血管堵塞，并对内皮功能产生有害影响，从而导致“无复流”现象、室性心律失常、冠状动脉血管储备丧失，或许还会导致细胞损伤的扩展。本综述探讨细胞间相互作用的机制，特别关注心肌缺血以及开发改进治疗方法以保护和保存缺血心肌的潜力。
