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铁死亡及其在急性胰腺炎中的新兴作用。

Ferroptosis and its emerging roles in acute pancreatitis.

机构信息

Department of Emergency, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu 730030, China.

出版信息

Chin Med J (Engl). 2022 Sep 5;135(17):2026-2034. doi: 10.1097/CM9.0000000000002096.

Abstract

Acute pancreatitis (AP) is a common and potentially life-threatening pancreatic inflammatory disease. Although it is usually self-limiting, up to 20% of patients will develop into severe AP. It may lead to systemic inflammatory response syndrome and multiple organ dysfunction, affecting the lungs, kidneys, liver, heart, etc. Surviving patients usually have sequelae of varying degrees, such as chronic hyperglycemia after AP (CHAP), pancreatic exocrine insufficiency, and chronic pancreatitis. Lacking specific target treatments is the main reason for high mortality and morbidity, which means that more research on the pathogenesis of AP is needed. Ferroptosis is a newly discovered regulated cell death (RCD), originally described in cancer cells, involving the accumulation of iron and the depletion of plasma membrane polyunsaturated fatty acids, and a caspase-independent RCD. It is closely related to neurological diseases, myocardial infarction, ischemia/reperfusion injury, cancer, etc. Research in the past years has also found the effects of ferroptosis in AP, pancreatic cancer, and AP complications, such as acute lung injury and acute kidney injury. This article reviews the research progress of ferroptosis and its association with the pathophysiological mechanisms of AP, trying to provide new insight into the pathogenesis and treatment of AP, facilitating the development of better-targeted drugs.

摘要

急性胰腺炎(AP)是一种常见且潜在危及生命的胰腺炎症性疾病。尽管它通常是自限性的,但仍有高达 20%的患者会发展为重症 AP。它可能导致全身炎症反应综合征和多器官功能障碍,影响肺、肾、肝、心等器官。幸存的患者通常会有不同程度的后遗症,如 AP 后慢性高血糖(CHAP)、胰腺外分泌功能不全和慢性胰腺炎。缺乏特定的靶向治疗是导致高死亡率和发病率的主要原因,这意味着需要对 AP 的发病机制进行更多的研究。铁死亡是一种新发现的受调控的细胞死亡(RCD),最初在癌细胞中描述,涉及铁的积累和细胞膜多不饱和脂肪酸的耗竭,是一种不依赖于胱天蛋白酶的 RCD。它与神经退行性疾病、心肌梗死、缺血/再灌注损伤、癌症等密切相关。近年来的研究还发现了铁死亡在 AP、胰腺癌和 AP 并发症(如急性肺损伤和急性肾损伤)中的作用。本文综述了铁死亡及其与 AP 病理生理机制的关联的研究进展,试图为 AP 的发病机制和治疗提供新的见解,促进更有针对性药物的开发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2a5/9746729/52e80cb8fff7/cm9-135-2026-g001.jpg

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