Gao Yuhan, Li Lu, Zhang Yuejun, Chu Yanlong, Han Guang
Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, China.
Front Cell Dev Biol. 2024 Dec 23;12:1524723. doi: 10.3389/fcell.2024.1524723. eCollection 2024.
Ischemia-reperfusion injury is a serious clinical pathology involving multiple organs such as the heart and brain. The injury results from oxidative stress, inflammatory response and cell death triggered by restoring tissue blood flow after ischemia, leading to severe cell and tissue damage. In recent years, the volume-regulated anion channel (VRAC) has gained attention as an important membrane protein complex. VRAC plays a dual role in ischemia-reperfusion injury: on the one hand, activated VRAC promotes the release of intracellular chloride and glutamate, exacerbating cellular swelling and excitotoxicity, and on the other hand, the regulatory effect of VRAC may also provide protection to cardiomyocytes. This article reviews the pathophysiological mechanisms of ischemia-reperfusion injury, existing therapeutic strategies and their limitations, focuses on the molecular structure of VRAC, its activation mechanism, and its role in ischemia-reperfusion injury, and concludes with a discussion of the potential of targeted inhibition of VRAC as an emerging therapeutic strategy and the challenges it faces. A deeper understanding of the role of VRAC in ischemia-reperfusion injury is expected to provide new therapeutic ideas to improve patient prognosis.
缺血再灌注损伤是一种严重的临床病理状态,涉及心脏和大脑等多个器官。这种损伤是由缺血后恢复组织血流引发的氧化应激、炎症反应和细胞死亡所致,会导致严重的细胞和组织损伤。近年来,容积调节性阴离子通道(VRAC)作为一种重要的膜蛋白复合物受到了关注。VRAC在缺血再灌注损伤中发挥着双重作用:一方面,激活的VRAC促进细胞内氯离子和谷氨酸的释放,加剧细胞肿胀和兴奋性毒性;另一方面,VRAC的调节作用也可能为心肌细胞提供保护。本文综述了缺血再灌注损伤的病理生理机制、现有的治疗策略及其局限性,重点阐述了VRAC的分子结构、激活机制及其在缺血再灌注损伤中的作用,并最后讨论了靶向抑制VRAC作为一种新兴治疗策略的潜力及其面临的挑战。对VRAC在缺血再灌注损伤中作用的更深入理解有望为改善患者预后提供新的治疗思路。