Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Front Immunol. 2022 Apr 21;13:826943. doi: 10.3389/fimmu.2022.826943. eCollection 2022.
Heart transplantation remains the optimal treatment option for patients with end-stage heart disease. Growing evidence demonstrates that purinergic signals mediated by purine nucleotides and nucleosides play vital roles in heart transplantation, especially in the era of ischemia-reperfusion injury (IRI) and allograft rejection. Purinergic signaling consists of extracellular nucleotides and nucleosides, ecto-enzymes, and cell surface receptors; it participates in the regulation of many physiological and pathological processes. During transplantation, excess adenosine triphosphate (ATP) levels are released from damaged cells, and driver detrimental inflammatory responses largely purinergic P2 receptors. Ecto-nucleosidases sequentially dephosphorylate extracellular ATP to ADP, AMP, and finally adenosine. Adenosine exerts a cardioprotective effect by its anti-inflammatory, antiplatelet, and vasodilation properties. This review focused on the role of purinergic signaling in IRI and rejection after heart transplantation, as well as the clinical applications and prospects of purinergic signaling.
心脏移植仍然是终末期心脏病患者的最佳治疗选择。越来越多的证据表明，嘌呤能信号通过嘌呤核苷酸和核苷介导，在心脏移植中发挥着重要作用，特别是在缺血再灌注损伤（IRI）和同种异体移植排斥的时代。嘌呤能信号包括细胞外核苷酸和核苷、膜表面受体和外核苷酸酶；它参与许多生理和病理过程的调节。在移植过程中，受损细胞释放过多的三磷酸腺苷（ATP），驱动有害的炎症反应主要通过嘌呤能 P2 受体。外核苷酸酶依次将细胞外 ATP 去磷酸化为 ADP、AMP，最终为腺苷。腺苷通过其抗炎、抗血小板和血管扩张特性发挥心脏保护作用。本综述重点介绍了嘌呤能信号在心脏移植后 IRI 和排斥反应中的作用，以及嘌呤能信号的临床应用和前景。
