Department of Pulmonary and Critical Care Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, P. R. China.
Department of Gynaecology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, P. R. China.
Clin Transl Med. 2024 Aug;14(8):e1808. doi: 10.1002/ctm2.1808.
Although interactions between the nervous and immune systems have been recognized decades ago, it has become increasingly appreciated that neuroimmune crosstalk is among the driving factors of multiple pulmonary inflammatory diseases including acute lung injury (ALI). Here, we review the current understanding of nerve innervations towards the lung and summarize how the neural regulation of immunity and inflammation participates in the onset and progression of several lung diseases, especially ALI. We then present advancements in the development of potential drugs for ALI targeting neuroimmune interactions, including cholinergic anti-inflammatory pathway, sympathetic-immune pathway, purinergic signalling, neuropeptides and renin-angiotensin system at different stages from preclinical investigation to clinical trials, including the traditional Chinese medicine.
This review highlights the importance of considering the therapeutic strategy of inflammatory diseases within a conceptual framework that integrates classical inflammatory cascade and neuroimmune circuits, so as to deepen the understanding of immune modulation and develop more sophisticated approaches to treat lung diseases represented by ALI.
The lungs present abundant nerve innervations. Neuroimmune interactions exert a modulatory effect in the onset and progression of lung inflammatory diseases, especially acute lung injury. The advancements of potential drugs for ALI targeting neuroimmune crosstalk at different stages from preclinical investigation to clinical trials are elaborated. Point out the direction for the development of neuroimmune pharmacology in the future.
尽管神经系统与免疫系统之间的相互作用在几十年前就已被认识到,但人们越来越认识到,神经免疫串扰是多种肺部炎症性疾病(包括急性肺损伤(ALI))的驱动因素之一。在这里,我们回顾了目前对肺神经支配的理解,并总结了神经对免疫和炎症的调节如何参与几种肺部疾病(尤其是 ALI)的发病和进展。然后,我们介绍了针对神经免疫相互作用的 ALI 潜在药物开发的进展,包括胆碱能抗炎途径、交感神经-免疫途径、嘌呤能信号、神经肽和肾素-血管紧张素系统,从临床前研究到临床试验,包括中药,都有涉及。
本综述强调了在一个综合经典炎症级联和神经免疫回路的概念框架内考虑炎症性疾病治疗策略的重要性,以便加深对免疫调节的理解,并开发出更复杂的方法来治疗以 ALI 为代表的肺部疾病。
肺部有丰富的神经支配。神经免疫相互作用在肺部炎症性疾病(尤其是急性肺损伤)的发病和进展中发挥调节作用。阐述了针对 ALI 神经免疫串扰的潜在药物在从临床前研究到临床试验的不同阶段的进展。指出了神经免疫药理学未来的发展方向。