髓过氧化物酶在心房颤动和缺血性心脏病中的作用

G. F. Bunenkova, S. Salikova, V. Grinevich, E. S. Ivanyuk
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摘要

心房颤动和缺血性心脏病是心脏病学的关键问题。尽管进行了大量的临床试验和研究,但分子生物学的基础仍然不确定。心房颤动和缺血性心脏病经常合并。在缺血性心脏病进展过程中,心肌组织结构发生变化,导致结构和电生理重塑,并促进心房颤动。氧化应激和慢性全身炎症在缺血性心脏病和心房颤动中起着至关重要的作用。髓过氧化物酶(MPO)是氧化应激和炎症的标志物之一,位于中性粒细胞和单核细胞的嗜蓝颗粒中。有许多文章显示MPO水平与心血管疾病之间的关系。MPO是一种过氧化物酶,是免疫系统的重要组成部分。在疾病期间,MPO可通过活性氧形式促进慢性炎症和局部组织损伤。溶酶体与吞噬体结合后MPO释放。MPO的氧还原酶活性导致次氯酸的合成,次氯酸不仅在机体免受感染方面发挥作用,而且在基质转化和纤维化方面发挥作用。研究表明,MPO可以破坏动脉粥样硬化斑块的稳定,并修饰低密度和高密度脂蛋白,从而促进动脉粥样硬化和缺血性心脏病的发展。本文综述了MPO在心房颤动和缺血性心脏病发病机制中的作用。
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Role of myeloperoxidase in atrial fibrillation and ischemic heart disease
Atrial fibrillation and ischemic heart disease are the key problems in cardiology. Despite of numerous clinical trials and researches underlying molecular biology remains uncertain. Atrial fibrillation and ischemic heart disease are often combined. During ischemic heart disease progression myocardial tissue structure are changing which lead to structural and electrophysiological remodeling and promote atrial fibrillation. It has been shown a crucial role of oxidative stress and chronic systemic inflammation in ischemic heart disease and atrial fibrillation. Myeloperoxidase (MPO) is one of marker of oxidative stress and inflammation that located in azurophilic granules of neutrophils and monocytes. There are a numerous articles showed a relation between MPO level and cardiovascular disease. MPO is a peroxidase enzyme that is important part of immune system. During disease MPO could facilitate chronic inflammation and local tissue damage through active oxygen forms. MPO releases after lysosome conjunction with phagosome. Oxygen reductase activity of MPO lead synthesis of hypochlorous acid that play role not only in organism protection from infection agents but in matrix transformation and fibrosis. It has been shown MPO can destabilize atherosclerotic plaque and modifies low- and high-density lipoproteins that promote atherosclerosis and ischemic heart diseaseу progression. This review summarizes current data about role of MPO in atrial fibrillation and ischemic heart disease pathogenesis.
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