急性心肌梗死中的细胞死亡调控:分子机制和治疗意义。

Lili Zhu, Yiyang Liu, Kangkai Wang, Nian Wang
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摘要

急性心肌梗死(AMI)主要由冠状动脉粥样硬化引起,引发一系列事件,最终导致冠状动脉阻塞,导致严重的心肌缺血和缺氧。随后的心肌缺血/再灌注(I/R)损伤进一步加重心脏损伤,导致心功能下降和危及生命的并发症风险。多种调控细胞死亡(RCD)通路的复杂相互作用在AMI的发病机制中起着关键作用。每个RCD通路都是由一系列分子调控机制精心策划的,突出了关键效应分子的动态变化和关键作用。对这些分子靶点的战略性破坏或抑制为减轻甚至避免RCD的发作提供了诱人的前景,从而限制了心肌细胞的广泛损失和有害心肌纤维化的进展。本文系统总结了各种形式的RCD的发病机制,从RCD的角度深入探讨了AMI的发病机制,并强调了一系列有希望的治疗靶点,这些靶点有可能彻底改变AMI的治疗方法。
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Regulated cell death in acute myocardial infarction: Molecular mechanisms and therapeutic implications.

Acute myocardial infarction (AMI), primarily caused by coronary atherosclerosis, initiates a series of events that culminate in the obstruction of coronary arteries, resulting in severe myocardial ischemia and hypoxia. The subsequent myocardial ischemia/reperfusion (I/R) injury further aggravates cardiac damage, leading to a decline in heart function and the risk of life-threatening complications. The complex interplay of multiple regulated cell death (RCD) pathways plays a pivotal role in the pathogenesis of AMI. Each RCD pathway is orchestrated by a symphony of molecular regulatory mechanisms, highlighting the dynamic changes and critical roles of key effector molecules. Strategic disruption or inhibition of these molecular targets offers a tantalizing prospect for mitigating or even averting the onset of RCD, thereby limiting the extensive loss of cardiomyocytes and the progression of detrimental myocardial fibrosis. This review systematically summarizes the mechanisms underlying various forms of RCD, provides an in-depth exploration of the pathogenesis of AMI through the lens of RCD, and highlights a range of promising therapeutic targets that hold the potential to revolutionize the management of AMI.

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