线粒体DNA释放触发的先天免疫机制在代谢相关脂肪性肝病中的作用及靶向干预策略
DOI: 10.12449/JCH260832
Role of innate immune mechanisms triggered by mitochondrial DNA release in metabolic dysfunction-associated fatty liver disease and targeted intervention strategies
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摘要: 代谢相关脂肪性肝病(MAFLD)是全球发病率最高的慢性肝病,其发病机制复杂。线粒体在该疾病进程中发挥关键作用,研究证实线粒体功能障碍可加剧代谢紊乱、诱发先天免疫失衡,而线粒体DNA(mtDNA)是介导这两大病理效应的核心分子。mtDNA异常释放后,可被细胞内模式识别受体识别,进而触发先天免疫反应并引发组织损伤,形成“mtDNA释放-免疫激活-组织损伤”的病理通路。目前,该通路在MAFLD疾病不同阶段的作用机制以及靶向该通路的干预策略,尚缺乏系统性的综述总结。本文系统综述该通路的核心分子机制、在MAFLD发生发展中的病理作用及当前靶向该机制的干预策略,旨在为MAFLD的病理机制解析与新型治疗策略的开发提供理论依据。Abstract: Metabolic dysfunction-associated fatty liver disease (MAFLD) is the most prevalent chronic liver disease worldwide, with a complex pathogenesis. Mitochondria play a pivotal role in this disease process, and studies have confirmed that mitochondrial dysfunction can exacerbate metabolic disorders and induce innate immune imbalance, while mitochondrial DNA (mtDNA) is the core molecule mediating these two pathological effects. After the abnormal release of mtDNA, it can be recognized by intracellular pattern recognition receptors, which in turn triggers innate immune responses and causes tissue damage, forming a pathological pathway of “mtDNA release-immune activation-tissue damage”. Currently, there is a lack of systematic reviews summarizing the mechanism of action of this pathway in different stages of MAFLD and the intervention strategies targeting this pathway. This article systematically reviews the core molecular mechanism of this pathway, its pathological role in the development and progression of MAFLD, and the current intervention strategies targeting this mechanism, in order to provide a theoretical basis for analyzing the pathogenesis of MAFLD and developing novel therapeutic strategies.
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注: cGAS,环鸟苷酸-腺苷酸合酶;cGAMP,环鸟苷酸-腺苷酸;STING,干扰素基因刺激因子;TBK1,TANK结合激酶1;IRF3,干扰素调节因子3;IKK,IκB激酶;TNF-α,肿瘤坏死因子α;IL-6,白细胞介素6;NLRP3,核苷酸结合寡聚结构域样受体家族热蛋白结构域相关蛋白3;Caspase-1,胱天蛋白酶1;IL-1β,白细胞介素1β;IL-18,白细胞介素18;TLR9,Toll样受体9;MyD88,髓系分化初级反应蛋白质88;NF-κB,核因子κB。
图 1 线粒体DNA触发先天免疫机制的信号通路
Figure 1. Signal pathway of innate immune mechanisms triggered by mitochondrial DNA
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