Department of Internal Medicine, National Taiwan University Hospital, Taipei 10002, Taiwan.
Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei 10002, Taiwan.
Cells. 2021 Dec 2;10(12):3402. doi: 10.3390/cells10123402.
Systemic sclerosis (SSc) is a chronic connective tissue disorder characterized by immune dysregulation, chronic inflammation, vascular endothelial cell dysfunction, and progressive tissue fibrosis of the skin and internal organs. Moreover, increased cancer incidence and accelerated aging are also found. The increased cancer incidence is believed to be a result of chromosome instability. Accelerated cellular senescence has been confirmed by the shortening of telomere length due to increased DNA breakage, abnormal DNA repair response, and telomerase deficiency mediated by enhanced oxidative/nitrative stresses. The immune dysfunctions of SSc patients are manifested by excessive production of proinflammatory cytokines IL-1, IL-6, IL-17, IFN-α, and TNF-α, which can elicit potent tissue inflammation followed by tissue fibrosis. Furthermore, a number of autoantibodies including anti-topoisomerase 1 (anti-TOPO-1), anti-centromere (ACA or anti-CENP-B), anti-RNA polymerase enzyme (anti-RNAP III), anti-ribonuclear proteins (anti-U1, U2, and U11/U12 RNP), anti-nucleolar antigens (anti-Th/T0, anti-NOR90, anti-Ku, anti-RuvBL1/2, and anti-PM/Scl), and anti-telomere-associated proteins were also found. Based on these data, inflamm-aging caused by immune dysfunction-mediated inflammation exists in patients with SSc. Hence, increased cellular senescence is elicited by the interactions among excessive oxidative stress, pro-inflammatory cytokines, and autoantibodies. In the present review, we will discuss in detail the molecular basis of chromosome instability, increased oxidative stress, and functional adaptation by deranged immunome, which are related to inflamm-aging in patients with SSc.
系统性硬化症(SSc)是一种慢性结缔组织疾病,其特征为免疫失调、慢性炎症、血管内皮细胞功能障碍以及皮肤和内脏器官的进行性纤维化。此外,还发现癌症发病率增加和加速衰老。癌症发病率的增加被认为是由于染色体不稳定。由于增强的氧化/硝化应激导致的 DNA 断裂增加、异常的 DNA 修复反应以及端粒酶缺乏,端粒长度缩短,从而证实了细胞衰老的加速。SSc 患者的免疫功能障碍表现为促炎细胞因子 IL-1、IL-6、IL-17、IFN-α和 TNF-α的过度产生,这些细胞因子可引发强烈的组织炎症,随后发生组织纤维化。此外,还发现了许多自身抗体,包括抗拓扑异构酶 1(抗-TOPO-1)、抗着丝粒(ACA 或抗-CENP-B)、抗 RNA 聚合酶酶(抗-RNAP III)、抗核糖核蛋白(抗-U1、U2 和 U11/U12 RNP)、抗核仁抗原(抗-Th/T0、抗-NOR90、抗-Ku、抗-RuvBL1/2 和抗-PM/Scl)和抗端粒相关蛋白。基于这些数据,免疫功能障碍介导的炎症引起的炎症性衰老存在于 SSc 患者中。因此,过多的氧化应激、促炎细胞因子和自身抗体之间的相互作用会引起细胞衰老。在本综述中,我们将详细讨论染色体不稳定、氧化应激增加和免疫失调引起的功能适应的分子基础,这些与 SSc 患者的炎症性衰老有关。