Hu Jiannan, Liu Shuchang, Ma Tao
Department of General Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China. Corresponding author: Ma Tao, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2021 Jan;33(1):122-125. doi: 10.3760/cma.j.cn121430-20200421-00318.
The cholinergic anti-inflammatory pathway (CAP) is an important neuroimmunomodulatory mechanism that innervates the spleen through vagus nerve efferent and splenic nerve relay, and acts on macrophages by transforming adrenergic stimulation into cholinergic signal by spleen T cells, which plays an anti-inflammatory effect, and maintains the balance of inflammatory response. Due to the critical role of the imbalance of pro-inflammatory and anti-inflammatory responses in the physiological process of sepsis, regulating the activity of the CAP has become an important focus in the treatments of sepsis. Based on the understanding of the CAP, vagus nerve stimulation, drug agonists mimicking cholinergic signals, and acupuncture are currently applied in the research and exploration of sepsis treatment. This article summarizes the recent progress and prospects of the CAP mechanism, biological effects, and application in sepsis treatment.
胆碱能抗炎通路(CAP)是一种重要的神经免疫调节机制,它通过迷走神经传出纤维和脾神经中继支配脾脏,并通过脾脏T细胞将肾上腺素能刺激转化为胆碱能信号作用于巨噬细胞,发挥抗炎作用,维持炎症反应的平衡。由于促炎和抗炎反应失衡在脓毒症生理过程中起关键作用,调节CAP的活性已成为脓毒症治疗的重要研究热点。基于对CAP的认识,目前迷走神经刺激、模拟胆碱能信号的药物激动剂及针刺疗法已应用于脓毒症治疗的研究探索中。本文综述了CAP机制、生物学效应及其在脓毒症治疗中的应用的最新研究进展与前景。