Guang'anmen Hospital, China Academy of Chinese Medicine Sciences, Beijing 100053, China.
Guang'anmen Hospital, China Academy of Chinese Medicine Sciences, Beijing 100053, China.
Biomed Pharmacother. 2023 Oct;166:115306. doi: 10.1016/j.biopha.2023.115306. Epub 2023 Aug 10.
Acute myocardial infarction (MI), despite significant progress in its treatment, remains a leading cause of chronic heart failure and cardiovascular events such as cardiac arrest. Promoting angiogenesis in the myocardial tissue after MI to restore blood flow in the ischemic and hypoxic tissue is considered an effective treatment strategy. The repair of the myocardial tissue post-MI involves a robust angiogenic response, with mechanisms involved including endothelial cell proliferation and migration, capillary growth, changes in the extracellular matrix, and stabilization of pericytes for neovascularization. In this review, we provide a detailed overview of six key pathways in angiogenesis post-MI: the PI3K/Akt/mTOR signaling pathway, the Notch signaling pathway, the Wnt/β-catenin signaling pathway, the Hippo signaling pathway, the Sonic Hedgehog signaling pathway, and the JAK/STAT signaling pathway. We also discuss novel therapeutic approaches targeting these pathways, including drug therapy, gene therapy, protein therapy, cell therapy, and extracellular vesicle therapy. A comprehensive understanding of these key pathways and their targeted therapies will aid in our understanding of the pathological and physiological mechanisms of angiogenesis after MI and the development and application of new treatment strategies.
急性心肌梗死（MI），尽管在治疗方面取得了重大进展，但仍是慢性心力衰竭和心血管事件（如心脏骤停）的主要原因。促进 MI 后心肌组织中的血管生成以恢复缺血和缺氧组织中的血流被认为是一种有效的治疗策略。MI 后心肌组织的修复涉及到强大的血管生成反应，涉及的机制包括内皮细胞增殖和迁移、毛细血管生长、细胞外基质的变化以及周细胞的稳定以促进新血管生成。在这篇综述中，我们详细介绍了 MI 后血管生成的六个关键途径：PI3K/Akt/mTOR 信号通路、Notch 信号通路、Wnt/β-catenin 信号通路、Hippo 信号通路、Sonic Hedgehog 信号通路和 JAK/STAT 信号通路。我们还讨论了针对这些途径的新型治疗方法，包括药物治疗、基因治疗、蛋白质治疗、细胞治疗和细胞外囊泡治疗。全面了解这些关键途径及其靶向治疗方法将有助于我们理解 MI 后血管生成的病理和生理机制，以及新治疗策略的开发和应用。
