Song Wenyu, Tu Guowei, Qin Lieyang, Wei Lai, Chen Jinmiao
Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, 200032 Shanghai, China.
Cardiac Intensive Care Center, Zhongshan Hospital, Fudan University, 200032 Shanghai, China.
Rev Cardiovasc Med. 2023 Nov 30;24(12):340. doi: 10.31083/j.rcm2412340. eCollection 2023 Dec.
Thoracic aortic aneurysm and dissection (TAAD) is a life-threatening cardiovascular disorder lacking effective clinical pharmacological therapies. The underlying molecular mechanisms of TAAD still remain elusive with participation of versatile cell types and components including endothelial cells (ECs), smooth muscle cells (SMCs), fibroblasts, immune cells, and the extracellular matrix (ECM). The main pathological features of TAAD include SMC dysfunction, phenotypic switching, and ECM degradation, which is closely associated with inflammation and immune cell infiltration. Among various types of immune cells, macrophages are a distinct participator in the formation and progression of TAAD. In this review, we first highlight the important role of inflammation and immune cell infiltration in TAAD. Furthermore, we discuss the role of macrophages in TAAD from the aspects of macrophage origination, classification, and functions. On the basis of experimental and clinical studies, we summarize key regulators of macrophages in TAAD. Finally, we review how targeting macrophages can reduce TAAD in murine models. A better understanding of the molecular and cellular mechanisms of TAAD may provide novel insights into preventing and treating the condition.
胸主动脉瘤和夹层（TAAD）是一种危及生命的心血管疾病，缺乏有效的临床药物治疗方法。TAAD的潜在分子机制仍然难以捉摸，涉及多种细胞类型和成分，包括内皮细胞（ECs）、平滑肌细胞（SMCs）、成纤维细胞、免疫细胞和细胞外基质（ECM）。TAAD的主要病理特征包括SMC功能障碍、表型转换和ECM降解，这与炎症和免疫细胞浸润密切相关。在各种类型的免疫细胞中，巨噬细胞是TAAD形成和进展中的独特参与者。在这篇综述中，我们首先强调炎症和免疫细胞浸润在TAAD中的重要作用。此外，我们从巨噬细胞的起源、分类和功能方面讨论巨噬细胞在TAAD中的作用。基于实验和临床研究，我们总结了TAAD中巨噬细胞的关键调节因子。最后，我们回顾了靶向巨噬细胞如何在小鼠模型中减少TAAD。更好地理解TAAD的分子和细胞机制可能为预防和治疗该疾病提供新的见解。
