| 亓秋琳,刘维英▲,胡梦佳,等.代谢-免疫交叉对话：巨噬细胞极化在肥胖型哮喘中的作用与靶向治疗前景[J].安徽医药,待发表. |
| 代谢-免疫交叉对话：巨噬细胞极化在肥胖型哮喘中的作用与靶向治疗前景 |
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| 投稿时间：2025-09-28 录用日期：2025-11-14 |
| DOI： |
| 中文关键词: 支气管哮喘 肥胖 巨噬细胞极化 代谢重编程 靶向治疗 |
| 英文关键词: |
| 基金项目:甘肃省自然科学基金资助项目(21JR1RA074)； |
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| 摘要点击次数: 36 |
| 全文下载次数: 0 |
| 中文摘要: |
| 肥胖型哮喘是一种以非Th2炎症和激素抵抗为特征的难治性哮喘表型,其发病机制独立于经典的Th2免疫通路,临床管理面临严峻挑战。近年研究发现,“代谢-免疫”交叉对话是其核心病理生理基础,而巨噬细胞极化在其中扮演了承上启下的关键角色。本综述系统阐述,在肥胖状态下,脂肪组织微环境通过代谢重编程、脂肪因子网络失衡及相关信号通路激活,驱动脂肪组织巨噬细胞向促炎M1表型极化,引发全身性低度炎症。这些炎症信号经循环系统通过“脂肪-气道轴”实现对肺部免疫的远程调控,扰乱肺泡巨噬细胞稳态,使其同样向M1表型偏移,进而形成主导以中性粒细胞浸润为特征的气道炎症。基于此,本文进而展望了靶向该过程的治疗新策略,为重塑免疫稳态、实现肥胖型哮喘的精准防治提供了新的理论依据与方向。 |
| 英文摘要: |
| Obesity-related asthma is a refractory asthma phenotype characterized by a pathogenesis distinct from the classical Th2 immune pathway, presenting considerable challenges in clinical management. Emerging evidence indicates that "metabolism–immune" crosstalk constitutes the core pathophysiological basis of this condition, with macrophage polarization serving as a critical mechanistic link. This review systematically outlines how, under obese conditions, the adipose tissue microenvironment promotes the polarization of adipose tissue macrophages toward a pro-inflammatory M1 phenotype through metabolic reprogramming, disruption of the adipokine network, and activation of associated signaling pathways, thereby instigating systemic low-grade inflammation. These inflammatory signals are propagated via the circulation and mediate remote regulation of pulmonary immunity through the "adipose–airway axis," disrupting alveolar macrophage homeostasis and skewing them toward an M1-like phenotype. Consequently, this process drives the development of neutrophilic airway inflammation. Based on these insights, we discuss emerging therapeutic strategies targeting this macrophage-centered pathway, offering a novel theoretical foundation and future directions for reestablishing immune homeostasis and enabling precise management of obesity-associated asthma. |
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