作　　者： (屠国伟）; (任杨华）; (史懿）; (马国光）; (郝光伟）; (罗哲）;

机构地区： 复旦大学附属中山医院重症医学科,上海200032

出　　处： 《中国临床医学》 2017年第3期470-475,共6页

摘　　要： 巨噬细胞是机体固有免疫的重要组成部分,其亚型(M1和M2)在特异性免疫应答的诱导与调节以及疾病的发展和恢复中起关键作用。急性肺损伤(acute lung injury,ALI)和急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)是严重的呼吸系统疾病。在ALI中,M1增加并分泌促炎细胞因子,在抵御病原入侵的同时也对肺部产生了急性损伤作用。M2可根据诱导因素的不同及功能的差异再细分为M2a、M2b、M2c等亚型,其中M2a起促进损伤修复的作用,M2b和M2c主要起免疫调节和免疫抑制的作用,M2c也可促进组织修复,有利于肺部损伤组织的愈合。M1与M2可以相互转化。在ALI的病程中,M1和M2需要保持平衡才能有效地清除病原物质,促进损伤的修复,而平衡的失调会导致ALI恶化,甚至进展为ARDS。本文主要针对巨噬细胞各亚型的特点及其与ALI的关系,M1和M2各自的极化和相互转化以及影响各亚型在不同时期平衡的因素作一综述。 Macrophages are important components of the innate immune system.Two major subtypes, M1 and M2, play a key role in the induction and regulation of specific immune responses, and in the development and recovery of diseases.Acute lung injury （ALI） and acute respiratory distress syndrome （ARDS） are a class of severe respiratory diseases.In ALI, M1 highly activates and releases proinflammatory cytokines, which produce acute lung injury damage such as pulmonary edema and increase vascular permeability while fighting against pathogen invasion.M2 can be further subdivided into M2a, M2b and M2c subtypes according to inducing factors and their respective functions.M2a plays a role in promoting injury repair.M2b and M2c mainly function in immune regulation and suppression.M2c can also promote tissue repair.M1 and M2 can be transformed into each other.In the course of ALI, the balance between M1 and M2 is important to remove pathogens and promote tissue repair.The imbalance between M1 and M2 will lead to ALI deterioration, and even progress to ARDS.The present paper reviews the characteristics of different subtypes of macrophages and their relationship with ALI, the polarization and mutual transformation of M1 and M2, and the factors that affect the balance of different subtypes at different stages.

关 键 词： 巨噬细胞亚型 急性肺损伤 平衡