牛文志 胡風云
[摘要] 多發性硬化(MS)是中樞神經系統(CNS)脫髓鞘病變。炎性反應是MS發展的重要因素,并可誘發小膠質細胞、巨噬細胞及CNS內星形膠質細胞的異常糖酵解。糖酵解過程中生成的毒性物質二羰基化合物甲基乙二醛(MGO)和乙二醛(GO)可與蛋白質中的氨基酸反應生成穩定的糖基化終末代謝產物(AGEs)。多發性硬化患者炎性反應使糖酵解增強,AGEs形成增加,而AGEs與糖基化終末產物受體(RAGE)結合進一步激活炎性反應。研究表明多發性硬化患者血液和腦組織中AGEs水平增加。因此,AGEs 參與了多發性硬化的炎性反應,在MS的病理過程中具有重要的作用。本文就AGEs在MS中的作用作一綜述。
[關鍵詞] 多發性硬化;糖基化終末代謝產物;糖基化終末產物受體;糖酵解
[中圖分類號] R744.51 [文獻標識碼] A [文章編號] 1673-9701(2018)23-0159-05
The role of advanced glycation end products on inflammatory response in multiple sclerosis
NIU Wenzhi1 HU Fengyun2
1.Shanxi Medical University, Taiyuan 030012, China; 2.Department of Neurology, Shanxi Provincial People's Hospital, Taiyuan 030012, China
[Abstract] Multiple sclerosis(MS) is a demyelinating disorder of the central nervous system (CNS). The inflammatory response is an important factor in the development of MS, and can induce abnormal glycolysis of microglia, macrophages, and astrocytes in the CNS. The toxic substances dicarbonyl compounds methyl glyoxal (MGO) and glyoxal (GO) generated during glycolysis react with the amino acids in the protein to form stable advanced glycation end products (AGEs).The inflammatory response in patients with multiple sclerosis enhances glycolysis and increases the formation of AGEs, whereas the binding of AGEs to receptors for glycation endproducts(RAGE) further activates inflammatory responses. Studies have shown the levels of AGEs in blood and brain tissue in multiple sclerosis patients increase. Therefore, AGEs are involved in the inflammatory response in multiple sclerosis and play an important role in the pathogenesis of MS. The role of AGEs in MS will be reviewed.
[Key words] Multiple sclerosis; Glycosylation end metabolites; Advanced glycation end products; Glycosylation end product receptors; Glycolysis
多發性硬化(multiple sclerosis,MS)是中樞神經系統(central nervous system,CNS)脫髓鞘病變。患者多在成年早期發病,表現為反復發作的神經功能障礙,多次緩解復發,病情每況愈下,甚至喪失工作能力,生活質量降低,背負沉重的醫療負擔。炎性反應參與了多發性硬化的病理過程。研究表明MS患者血液和腦組織中糖基化終末代謝產物(advanced glycation endproducts,AGEs)水平增加。AGEs 可能參與了MS的炎性反應并在其病理過程中發揮了重要作用。目前關于AGEs在多發性硬化癥中的作用日益受到關注。
1 MS和AGEs
1.1 MS
多發性硬化(MS)是一種中樞神經系統的炎性脫髓鞘疾病,多于成年早期發病,女性多見,分為復發-緩解型(relapsing-remitting,RR)、繼發進展型(secondary progressive,SP)、原發進展型(primary-progressive,PP)、進展復發型(progressive-relapsing ,PR)。可有多種臨床表現,如視力障礙、感覺異常、肢體無力、共濟失調等。……