Imiela Anna M, Kucharska Joanna, Kukliński Franciszek, Fernandez Moreno Teresa, Dzik Konrad, Pruszczyk Piotr
Department of Internal Diseases and Cardiology, Infant Jesus Clinical Hospital, Medical University of Warsaw, Lindleya 4 Street, 02-005 Warsaw, Poland.
Department of Intensive Cardiac Care, Medical University of Bialystok, 15-089 Białystok, Poland.
Biomedicines. 2025 Apr 8;13(4):906. doi: 10.3390/biomedicines13040906.
According to the literature, cardiovascular diseases (CVDs)-including myocardial infarction, stroke, and venous thromboembolism (VTE)-are among the leading causes of mortality and morbidity worldwide. Evidence suggests that CVDs share common risk factors and pathophysiological mechanisms. Similar to the Mosaic Theory of Hypertension proposed by Irvine Page in 1949, the pathophysiology of VTE is multifactorial, involving multiple interacting processes. The concept of immunothrombosis, introduced by Engelmann and Massberg in 2009, describes the interplay between the immune system and thrombosis. Both thrombosis and hemostasis share core mechanisms, including platelet activation and fibrin formation. Additionally, immune mediators-such as monocytes, neutrophil extracellular traps (NETs), lymphocytes, selectins, and various molecular factors-play a critical role in thrombus formation. This review highlights inflammation as a key risk factor for pulmonary embolism (APE). Immunity is central to the complex interactions among the coagulation cascade, platelets, endothelium, reactive oxygen species (ROS), and genetic factors. Specifically, we examine the roles of the endothelium, immune cells, and microRNAs (miRNAs) in the pathophysiology of APE and explore potential therapeutic targets. This review aims to elucidate the roles of the endothelium, immune cells, and miRNAs in the pathophysiology of APE and explore potential future perspective.
根据文献记载，心血管疾病（CVDs）——包括心肌梗死、中风和静脉血栓栓塞（VTE）——是全球范围内导致死亡和发病的主要原因之一。有证据表明，心血管疾病具有共同的风险因素和病理生理机制。与1949年欧文·佩奇提出的高血压镶嵌理论类似，静脉血栓栓塞的病理生理学是多因素的，涉及多个相互作用的过程。2009年恩格尔曼和马斯伯格提出的免疫血栓形成概念描述了免疫系统与血栓形成之间的相互作用。血栓形成和止血都有核心机制，包括血小板活化和纤维蛋白形成。此外，免疫介质——如单核细胞、中性粒细胞胞外陷阱（NETs）、淋巴细胞、选择素和各种分子因子——在血栓形成中起关键作用。本综述强调炎症是肺栓塞（APE）的关键风险因素。免疫在凝血级联、血小板、内皮、活性氧（ROS）和遗传因素之间的复杂相互作用中起着核心作用。具体而言，我们研究内皮、免疫细胞和微小RNA（miRNAs）在肺栓塞病理生理学中的作用，并探索潜在的治疗靶点。本综述旨在阐明内皮、免疫细胞和miRNAs在肺栓塞病理生理学中的作用，并探索潜在的未来前景。
