|
楼主 |
发表于 2008-12-16 15:14:20
|
显示全部楼层
6-5-第五节 小 结
血管内皮细胞在风湿病的发病过程中有重要的作用。各种致病因子,如前炎性细胞因子、自身抗体、炎症细胞等均可通过直接或间接途径作用于内皮细胞,引起内皮细胞损伤或细胞表型改变。同时,内皮细胞也通过自身激活表达多种粘附分子,释放大量炎症细胞因子和血管活性物质,介导炎症细胞的粘附、活化及迁移,并且使血管内皮系统从抗凝状态转变为促凝状态,最终导致炎症细胞在局部的浸润或血管内血栓形成,构成许多血管相关免疫性疾病的病理基础。 5 H$ z, V) v# ~' C, m, r k
% [5 H; e$ O2 q. t' z
目前在对血管内皮细胞的实验研究中尚存在一些问题。大多数对内皮细胞的体外实验均采用人脐静脉内皮细胞(HUVEC)作为研究对象。有资料表明,人脐静脉和脐动脉的内皮细胞在炎性细胞因子 IL-1, TNF、脂多糖等的刺激下,在 ICAM-1, VCAM-1的表达方面具有差别,TNF可以诱导这两种细胞均表达 ICAM-1,IL-1可以导致这两种细胞均表达VCAM-1,但TNF和 LPS处理后只导致 HUVEC表达VCAM-1。这提示动脉和静脉内皮细胞在炎性因子刺激下表达的粘附分子是有所不同的,并且可能会导致不同疾病的病变血管不同。在用免疫细胞化学方法对人体内的不同血管进行研究后发现,毛细血管的内皮细胞表达大量的主要组织相容性复合物(majorhistocompatibility complex, MHC) I和II、ICAM、 OKM5(单核细胞/内皮细胞标志),而大血管内皮表达大量的vW F和E-选择素,很少或几乎不表达MHC-I和II ,ICAM,OKM5。在对APS和SLE患者的研究中发现,来自相同组患者的血清抗体在HUVEC和人微血管内皮细胞 (human microvascular endothelial cell, HMEC)膜上的结合位点和结合率均有差异。因此不同来源的血管内皮细胞可能具有不同的表型,这可能会导致实验结果的不一致。另外,也需进一步研究反映内皮激活或损伤的指标及其检测方法,虽然目前已有检测可溶性粘附分子、可溶性血栓调理蛋白、vWF等的方法,但各个实验室取得的结果并不一致;并且它们在炎症反应中的作用及分布的细胞各有侧重并互相重叠,在反映内皮激活中的意义尚有待于进一步明确。最近,研究发现在SLE活动期患者的血清中,有表达活化表型的循环内皮细胞(circulating endothelial cell, CEC)数目的升高,并且与血浆 C3a的水平相关。提示它可能反映补体介导的内皮细胞损伤程度。但目前该循环内皮细胞的来源尚不清楚,在内皮激活或损伤中的意义有待于进一步实验来验证。7 k! G1 H6 Z8 T0 F6 c* H, k- Q2 u
( 韩 飞 孙仁宇 )/ @$ r" s8 D; X0 Z- l
, N% J; n7 Y0 M2 t. o
参考文献: ( w/ v& z' v, H$ X0 [2 g# ]
% {. R: Q/ Y, t% v 韩启德,文允锰.血管生物学.北京:中国协和医科大学北京医科大学联合出版社.1997.24一37,160一166 ( s+ \! z4 @: {
; p8 O' D( x( m% I' D5 q# Q) y! \" F 胡新伟,黎磊石.霉酚酸酷治疗免疫性肾小球疾病.肾脏病与透析肾移植杂志,2000.9(3):277
5 z0 I! V m/ m8 q h1 z
# p$ M8 l' N* }# p# S0 { \. F0 Q 蒋明,林孝义,朱立平.风湿病学.北京:科学出版社.1995.181一188,1137一1139 ' o" a# ~, o" ~ s/ U
4 u& J' g, i5 K" r5 |0 m
刘浩,刘志红,黄海东等.霉酚酸醋及地塞米松对血管内皮细胞功能的影响.肾脏病与透析肾移植杂志,2000.9(1):48一51 % {6 }6 A3 s; K$ \
/ y# y# z9 P: ?2 e
王海鹰,王丛妙,王德文等.全身调控一氧化氮水平对多发性关节炎大鼠颖下领关节的影响.解放军医学杂志,1999.24(1):38一40 / ^7 j4 y1 k2 u J
7 g/ N+ `+ J( s/ Y4 z# c
张乃峥.临床风湿病学.上海:上海科学技术出版社.1997.73一83,98一101 ( P5 Y0 d: c2 y. g: ]
( `' W4 ]$ L7 [1 ^
Atsumi T, Khamashta M A, Haworth R S et al. Arterial disease and thrombosis in the antiphospholipid syndrome: a pathogenic role for endothelia 1.Arthritis Rheum, 1998.41(5):800一807 ' \3 _0 X9 I( m1 n' T8 u
* c# x- B! R, j- f c _ Belmont H M, Levartovsky D, Goel A et al. Increased nitric oxide production accompanied by the up-regulation of inducible nitric oxide synthase in vascular endothelium from patients with systemic lupus erythematosus. Arthritis Rheum, 1997. 40(10):1810一1816
# J# T: J. n# v: d, [. W
( z$ n; B' [. z& w( { Blank M, Shoenfeld Y, Cabilly S et al. Prevention of experimental antiphospholipid syndrome and endothelial cell activation by synthetic peptides. Proc Natl Acad Sci USA, 1999. 96 (9):5164一5168
: V5 I4 r7 j* @! p
! H- g+ m- e; T/ R Boffa M C Karmochkine M. Thrombomodulin: an overview and potential implications in vascular disorders. Lupus,1998.7 Suppl2:S120一25
+ M2 o# o; z4 \( o ~
+ m! Y4 o' i) ^1 \1 u8 B' V- Y' W4 r Bratt J, Palmblad J. Cytokine-induced neutrophil-mediated injury of human endothelial cells. J Immunol.,1997.159(2):912一918
; Y v M. B: o
! z/ ~+ M7 R9 p Cacoub P, Hausfater P, Musset L et al. Mixed cryoglobulinemia in hepatitis C patients. Ann Med Interne (Paris),2000.151(1):20一29 4 Y( t# |; P1 f/ W2 ]$ ~9 |
% R2 x5 x |8 q1 H- u1 c
Carvalho D, Savage C O, Isenberg D et al. IgG anti-endothelial cell autoantibodies from patients with systemic lupus erythematosus or systemic vasculitis stimulate the release of two endothelial cell-derived mediators, which enhance adhesion molecule expression and leukocyte adhesion in an autocrine manner. Arthritis Rheum, 1999.42(4):631一640
1 |$ d; n) v2 Q% H! H; K% g' r, f' R% f
Christopher G, Daniel C. Roles of leukocyte/endothelial cell adhesion molecules in the pathogenesis of vasculitis. Am J Med.,1999.106:677一687
% z0 @# H$ l$ H# m8 ^; p4 I/ D. c' \& N& g- b5 V ?
Clancy R. Circulating endothelial cells and vascular injury in systemic lupus erythematosus. Curr Rheumatol Rep.,2000. 2(1):39一43 6 @; ]1 ?; Y+ |6 Z, D8 s& r$ i
3 `4 A- g1 s- ?6 ?3 T. v Clancy R, Marder G, Martin V et al. Circulating activated endothelial cells in systemic lupus erythematosus: further evidence for diffuse vasculopathy. Arthritis Rheum, 2001.44(5):1203一1208
) [% B/ n1 [. G- H4 {: w
% B) S# n+ J( y1 [ Claudy A. Pathogenesis of leukocytoclastic vasculitis. Eur J Dermatol, 1998.8(2):75一79 : I: j+ G! H9 S% ^
% E: Q5 z2 c5 {4 w* h Cockwell P, Tse W Y, Savage(‘O. Activation of endothelial cells in thrombosis and vasculitis. Scand J Rheumatol.,1997.26:145一150 3 f8 y5 \- @% s
$ G5 N0 h8 a3 e. w: ~$ ]2 G De Bandt M, Meyer O, Dacosta L et al. Anti-proteinase-3(PR3) antibodies (C-ANCA) recognize various targets on the human umbilical vein endothelial cell(HUVEC) membrane. Clin Exp Immunol.,1999.115(2):362一368 5 B- x* y/ L1 k8 \7 `
2 J4 S& b. @- i/ E
Del Papa N, Guidali L, Sala A et al. Endothelial cells as target for antiphospholipid antibodies: human polyclonal and monoclonal anti-beta 2-glycoprotein I antibodies react in vitro with endothelial cells through adherent beta 2-glycoprotein I and induce endothelial activation. Arthritis Rheum, 1997.40(3):551一561
+ n( b! \3 ]1 u8 C' r' s0 Z: @% h, P& ?( D2 W
Frampton G, Moriya S, Pearson J D et al. Identification of candidate endothelial cell autoantigens in systemic lupus erythematosus using a molecular cloning strategy PO as an endothelial cell autoantigena role for ribosomal:1114一1120
0 d8 j. Y8 ?8 S+ R1 `6 K% J& l+ J5 w
Frijns R, Fijnheer R, Schlel A el al Persistent increase in5m 月thrombomodulin in patients with a history of lupus nephri(3)endothelial cell activation markers. J Rheumatol.,2001.28:514一519 0 C$ _1 w8 H* `5 r* J+ {
$ r- t t5 t6 \# g. b3 | Garcia-Lopez M A, Sanchez-Madrid F, Rodriguez-Frade J M et al. CXCR3 chemokine receptor distribution in normal and inflamed tissues: expression on activated lymphocytes, endothelial cells, and dendritic cells. Lab Invest, 2001.81(3) :409一418
- ^$ g' q6 _8 }+ }) i, Z
7 U( r& t4 s4 X Gharavi A F, Pierangeli S S, Colden-Stanfield M et al. GD-KV-induced antiphospholipid antibodies enhance thrombosis and activate endothelial cells in vivo and in vitro. J Immunol.,1999.163(5):2922一2927 4 K3 F/ h, ]7 T4 h/ ?- o! }
5 @ b+ e' i( {. H3 g( p
Gross W L, Trabandt A, Csernok E. Pathogenesis of Wegener's granulomatosis. Ann Med Interne (Paris).,1998.149(5):280一286
/ m7 s, P8 c! s
/ O7 q; L* x2 n4 _' l0 r& D Hamamichi Y, Ichida F, Yu X et al. Neutrophils and mononuclear cells express vascular endothelial growth factor in acute Kawasaki disease: its possible role in progression of coronary artery lesions. Pediatr Res.,2001.49(1):74一80 " w) z, V) u1 r3 ^5 [
9 X8 Z% x* I& f5 Y! E! r. d! `
Harper L, Savage C O. Pathogenesis of ANCA-associated systemic vasculitis. J. Patholoy.,2000.190 349一359
9 Q; ` B1 y, J0 |' M9 y# q. p; t. D" B/ |, n
Hill M b Phipps JL; Hughes P et al. Anti-endothelial cell antibodies in primary antiphospholipid syndrome and SLE: pattems of reactivity with membrane antigens on microvascular and umbilical venous cell membranes. Br J Haematol.,1998. 103 416一421 7 `, M6 J5 m/ Q
& ]" s6 [- ~" T7 P Hippenstiel S, Krull M, Ikemann A et al. VEGF induces hyperpermeability by a direct action on endothelial cells. Am JPhysiol.,1998.274(5 Pt 1) L678684 ; p( ?$ z' a- }! A1 U7 X
k1 j! E/ D& K- Z! b3 U
Ihn H, Sato S, Fujimoto M et al. Characterization of autoantibodies to endothelial cells in systemic sclerosis (SSc):association with pulmonary fibrosis. Clin Exp Immunol.,2000.119(1):203一209 4 b: V, p- r. X9 E' [& n# T) \
% Z& n" K' i1 Q( O* u# y5 ~ D) i
Johnson P A, Alexander H D, McMillan S A. Up-regulationof the granulocyte adhesion molecule Mac-1 by autoantibodies in autoimmune vasculitis. Clin Exp Immunol.,1997.107(3):513 一519
! k( I' p# W2 `! W, _! [% [. o
* A! V0 N% J* p# p/ z Johnson P A, Alexander H D, McMillan S A et al. Up-regulation of the endothelial cell adhesion molecule intercellular adhesion molecule-1 (ICAM-1) by autoantibodies in autoimmune vasculitis. Clin Exp Immunol.,1997.108(2):234一242
" J( `* ~; N# l5 d$ a2 n7 s. e9 ?1 Q
Kalogeris T J, Kevil C G, Laroux F S et al. Differential monocyte adhesion and adhesion molecule expression in venous and arterial endothelial cells. Am J Physiol.,1999.276:9一19
- |1 u$ N4 S- R# P
3 e. ^. t" W0 Q0 E5 k) r- ^ Kornberg A, Renaudineau Y, Blank M et al. Anti-beta 2glycoprotein I antibodies and anti-endothelial cell antibodies induce tissue factor in endothelial cells. Isr Med Assoc J.,2000.2 Sup-pl:27一31
7 i4 `/ U0 ~2 P+ f. f9 I6 J* A; i8 \: H. l' H1 k
Kurosawa S, Esmon C T, Stearns-Kurosawa D J. The soluble endothelial protein C receptor binds to activated neutrophils: involvement of proteinase-3 and CDIIb/CD18. J Immunol.,2000.165(8):4697一4703 ! Q- W6 \- d I! y
' M: O" p# x# _3 z E6 w& }/ O Li C G, Reynolds I, Ponting JM et al. Serum levels of vascular endothelial growth factor (VEGF) are markedly elevated in patients with Wegener’s granulomatosis. Br J Rheumatol.,1998.37(12):1303一1306
1 u( ~; y! y' t2 \0 q# C! S+ a5 o( d4 s* Y" d
Ma K, Simantov R, Zhang J C et al. High affinity binding of beta 2-glycoprotein I to human endothelial cells is mediated by annexin II.J BiolChemHarari2000.275(20):15541一15548& ^4 |2 b4 M/ C% ]# I2 j
2 S0 ^& q& @( a# B }& C McHale J F,O A, Marshall D et al. TNF-alpha andIL-1 sequentially induce endothelial ICAM-1 and VCAM-1 expression in MRL/lpr lupus-prone mice. J Immunol.,1999. 163(7):3993一4000
# g2 j" d" i; d/ v' r2 g
% s0 F$ s M$ \7 o2 y# b Muller Kobold A C, van Wijk R T, Franssen C F et al. In vitro up-regulation of E-selectin and induction of interleukin-6 in endothelial cells by autoantibodies in Wegener' s granulomatosis and microscopic polyangiitis. Clin Exp Rheumatol.,1999. 17(4) :433一440
" T8 p7 n# K. Y5 i' s6 L5 N: F, O- t9 u7 j7 d6 D. Q
Nowack R; Flores-Suarez L F; van der Woude F J. New developments in pathogenesis of systemic vasculitis. Curr Opin Rheumatol.,1998.10(1):3一11
! u) i% D, ]7 P2 r' ~. \5 Q3 c2 N& T' Y" Y7 P3 q- \
Papa N D, Raschi E, Moroni G et al. Anti-endothelial cell IgG fractions from systemic lupus erythematosus patients bind to human endothelial cells and induce a pro-adhesive and a pro-inflammatory phenotype in vitro. Lupus, 1999.8(6) :423一429 $ u9 V7 j3 U2 f0 b3 j2 u( }
: U& x( Y6 S9 r- w1 o Pelletier J P. Jovanovic D. Manning P. Reduced progression of experimental osteoarthritis in vivo by selective inhibition of inducible nitric oxide synthase Arthritis Rheum, 1998.41:1275
$ f) U+ S* u' q7 ^. q/ I/ G! J: A9 R( T
Pierangeli S S, Colden-Stanfield M, Liu X et al. Antiphospholipid antibodies from antiphospholipid syndrome patients activate endothelial cells in vitro and in vivo. Circulation, 1999. 99(15):1997一2002 6 H. K' N6 k# B
" O* j0 u3 d9 N* E% r8 h
Pierangeli S S, Espinola R G, Liu X et al. Thrombogenic effects of antiphospholipid antibodies are mediated by intercellular cell adhesion molecule-1,vascular cell adhesion molecule-1,and P-selectin. Circ Res.,2001.88(2):245一250 $ _! ?0 q3 ~/ a$ U q& t8 `& R
) f3 F* J# `* `' A2 p# H
Praprotnik S, Rozman B, Blank M et al. Pathogenic role of anti-endothelial cell antibodies in systemic vasculitis. Wien Klin Wochenschr.,2000.112(15一16):660一664
/ Y# r i" \3 t% M3 O
v7 u2 p" G. u: r! d Praprotnik S, Rozman B, Blank M et al. Classification of anti-endothelial cell antibodies into antibodies against microvascular and macrovascular endothelial cells. Arthritis&Rheumatism,2001.44(7):1484一1494
) i* f+ I) e- M3 ^. N- W9 V$ ~1 D: e. j
Rand J H, Wu X X, Andree H A et al. Pregnancy loss in the antiphospholipid-antibody syndrome--a possible thrombogenic mechanism. N Engl J Med. 1997.337(3):154一160" o* C7 c- D* P! A
& R0 U) z5 t. M: f7 [+ e9 ^ Shaun Ruddy, Edward D. Harrisley's textbook of rheumatology, Saunders Co. 2001. 6th239Clement B. Sledge. KelEd. Philadelphia: W. B253,275一290, 1165-
+ Z. m r2 C+ \; g1 f1 Q$ Y) U- {' b
Sgonc R. The vascular perspective of systemic sclerosis: ofchickens, mice and men. Int Arch Allergy Immunol.,1999.120(3):169一176
# b( B0 w* R/ {7 y
/ P% a- x, ^) U9 Y: D- ]) I Song J, Park Y B, Lee W K et al. Clinical associations of anti-endothelial cell antibodies in patients with systemic lupus erythematosus. Rheumatol Int.,2000.20(1):1一7 + n% p9 @: T+ z, c4 ?1 S! P9 I/ T
8 z @7 g& D; h& P$ S. h+ A
Taekema-Roelvink M E, van Kooten C, Janssens M C et al.Effect of anti-neutrophil cytoplasmic antibodies on proteinase 3-induced apoptosis of human endothelial cells. Scand J Immunol.,1998.48(1):37一43
- z& z' w# {2 q5 c! y' P
; F; p& f, p* M, G1 P" U Taekema-Roelvink M E, Kooten C, Kooij S V et al. Proteinase 3 enhances endothelial monocyte chemoattractant protein-1 production and induces increased adhesion of neutrophils to endothelial cells by upregulating intercellular cell adhesion molecule-1.J Am Soc Nephrol. , 2001.12(5) :932一940 6 L+ L/ i, c1 }- J8 u& Y" h; a
1 E/ k% k: Z4 p5 I
Terai M, Yasukawa K, Narumoto S et al. Vascular endothelial growth factor in acute Kawasaki disease. Am J Cardiol.,1999.83(3):337一339 |
|