器官移植中缺血再灌注损伤的细胞损伤和细胞死亡的细胞和分子机制。

Cellular and molecular mechanisms of cell damage and cell death in ischemia-reperfusion injury in organ transplantation.

机构信息

Department of Pharmacology and Toxicology, School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.

Department of Physiology & Pharmacology, Accra College of Medicine, East Legon, Accra, Ghana.

出版信息

Mol Biol Rep. 2024 Mar 29;51(1):473. doi: 10.1007/s11033-024-09261-7.

Abstract

Ischemia-reperfusion injury (IRI) is a critical pathological condition in which cell death plays a major contributory role, and negatively impacts post-transplant outcomes. At the cellular level, hypoxia due to ischemia disturbs cellular metabolism and decreases cellular bioenergetics through dysfunction of mitochondrial electron transport chain, causing a switch from cellular respiration to anaerobic metabolism, and subsequent cascades of events that lead to increased intracellular concentrations of Na, H and Ca and consequently cellular edema. Restoration of blood supply after ischemia provides oxygen to the ischemic tissue in excess of its requirement, resulting in over-production of reactive oxygen species (ROS), which overwhelms the cells' antioxidant defence system, and thereby causing oxidative damage in addition to activating pro-inflammatory pathways to cause cell death. Moderate ischemia and reperfusion may result in cell dysfunction, which may not lead to cell death due to activation of recovery systems to control ROS production and to ensure cell survival. However, prolonged and severe ischemia and reperfusion induce cell death by apoptosis, mitoptosis, necrosis, necroptosis, autophagy, mitophagy, mitochondrial permeability transition (MPT)-driven necrosis, ferroptosis, pyroptosis, cuproptosis and parthanoptosis. This review discusses cellular and molecular mechanisms of these various forms of cell death in the context of organ transplantation, and their inhibition, which holds clinical promise in the quest to prevent IRI and improve allograft quality and function for a long-term success of organ transplantation.

摘要

缺血再灌注损伤(IRI)是一种严重的病理状态,细胞死亡在此过程中起着重要作用,并对移植后的结果产生负面影响。在细胞水平,由于缺血导致的缺氧扰乱了细胞代谢,并通过线粒体电子传递链功能障碍降低了细胞的生物能量,导致细胞呼吸向无氧代谢转变,随后发生一系列事件,导致细胞内 Na+、H+和 Ca2+浓度增加,进而导致细胞水肿。缺血后恢复血液供应会向缺血组织提供超过其需求的氧气,导致活性氧(ROS)的过度产生,这会超过细胞的抗氧化防御系统,从而导致氧化损伤,此外还会激活促炎途径导致细胞死亡。适度的缺血和再灌注可能导致细胞功能障碍,但由于激活了恢复系统来控制 ROS 的产生并确保细胞存活,因此不一定会导致细胞死亡。然而,长时间和严重的缺血再灌注通过细胞凋亡、线粒体分裂、坏死、坏死性凋亡、自噬、线粒体自噬、线粒体通透性转换(MPT)驱动的坏死、铁死亡、细胞焦亡、铜死亡和伴凋亡诱导细胞死亡。本综述讨论了这些不同形式的细胞死亡在器官移植中的细胞和分子机制,以及它们的抑制作用,这在防止 IRI 并改善移植物质量和功能以实现器官移植长期成功方面具有临床应用前景。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de3a/10980643/5a63696624c5/11033_2024_9261_Fig1_HTML.jpg

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