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中华诊断学电子杂志 ›› 2025, Vol. 13 ›› Issue (01) : 65 -70. doi: 10.3877/cma.j.issn.2095-655X.2025.01.010

综述

胆碱能α7 烟碱型乙酰胆碱受体通路对高原冲击性脑损伤后肺脏功能的影响研究进展
刘兴庆1, 孟祥洋1, 李森2, 王海燕2, 谢友红1, 杨策2,()   
  1. 1. 400050 重庆医科大学附属康复医院
    2. 400042 重庆,陆军军医大学大坪医院野战外科研究部创伤与化学中毒全国重点实验室
  • 收稿日期:2024-12-13 出版日期:2025-02-26
  • 通信作者: 杨策
  • 基金资助:
    军队后勤科研重大项目(ALJ22J002)

The research progress of the effect of cholinergic α7nAChR pathway on pulmonary function after plateau blast brain injury

Xingqing Liu1, Xiangyang Meng1, Sen Li2, Haiyan Wang2, Youhong Xie1, Ce Yang2,()   

  1. 1. Rehabilitation Hospital of Chongqing Medical University, Chongqing 400050, China
    2. National Key Laboratory of Trauma and Chemical Poisoning, Department of Field Surgery, Daping Hospital, Army Medical University, Chongqing 400042, China
  • Received:2024-12-13 Published:2025-02-26
  • Corresponding author: Ce Yang
引用本文:

刘兴庆, 孟祥洋, 李森, 王海燕, 谢友红, 杨策. 胆碱能α7 烟碱型乙酰胆碱受体通路对高原冲击性脑损伤后肺脏功能的影响研究进展[J/OL]. 中华诊断学电子杂志, 2025, 13(01): 65-70.

Xingqing Liu, Xiangyang Meng, Sen Li, Haiyan Wang, Youhong Xie, Ce Yang. The research progress of the effect of cholinergic α7nAChR pathway on pulmonary function after plateau blast brain injury[J/OL]. Chinese Journal of Diagnostics(Electronic Edition), 2025, 13(01): 65-70.

高原地区以其独特的地理环境和气候条件,对人体健康产生了显著的影响,尤其是其低氧、低气压的特点,增加了冲击性脑损伤的发生率和严重程度。 而肺脏作为气体交换的核心器官,其功能在高原环境下易受损害,进而加剧冲击性脑损伤后的肺部感染,增加死亡率,表现为炎症、水肿、出血等病理变化,可诱发急性呼吸窘迫综合征及神经源性肺水肿等严重并发症。 大脑和肺之间存在复杂的交互功能联系与信息传输。 迷走神经作为连接大脑与肺的关键神经通路之一,通过胆碱能抗炎通路(CAP)调控炎症反应、血管通透性等过程,对肺损伤伤情变迁与功能转归有重要影响。 α7烟碱型乙酰胆碱受体(α7nAChR)是该通路的基本组成部分,而孤束核(NTS)作为CAP 通路的关键节点,通过迷走神经接受来自肺的感觉输入,NTS 处理和整合这些信息,向其他脑干和前脑区域发送信号,发出迷走神经冲动,释放乙酰胆碱并传递至外周组织器官,以调节自主神经系统和心肺功能,发挥抗炎作用。 因此,本文系统回顾冲击性脑损伤对肺功能的影响及胆碱能α7nAChR 通路在其中的保护作用,为高原冲击伤的防治提供科学依据与策略启示。

The plateau region, with its unique geographical environment and climatic conditions,has a significant impact on human health. Especially its low oxygen and low air pressure increases the incidence and severity of traumatic brain injury. As the core organ of gas exchange, the function of the lungs is vulnerable to damage in the plateau environment, which in turn exacerbates pulmonary infection after traumatic brain injury and increases mortality rate. This is manifested through pathological changes such as inflammation, edema, and hemorrhage, potentially leading to severe complications such as acute respiratory distress syndrome and neurogenic pulmonary edema. There exists a complex bidirectional functional interaction and information transmission between the brain and lungs. The vagus nerve, as a key neural pathway connecting the brain and the lungs, has an important impact on lung injury by regulating inflammatory responses, vascular permeability and other processes through the cholinergic anti-inflammatory pathway(CAP). Among these, α7 nicotinic acetylcholine receptor (α7nAChR) is a fundamental component of the CAP pathway. The nucleus tractus solitarius (NTS), a key node of the CAP pathway, receives sensory inputs from the lungs via the vagus nerve. The NTS processes and integrates these information, sending signals to other brainstem and forebrain regions to elicit vagal impulses to release acetylcholine delivery to peripheral tissues and organs. This regulate the autonomic nervous system and cardiorespiratory function,exerting anti-inflammatory effects. Therefore, this paper systematically reviews the effects of traumatic brain injury on lung function and the protective role of the cholinergic α7nAChR pathway, providing scientific evidence and strategic insights for the prevention and treatment of plateau impact injuries.

图1 胆碱能α7nAChR 在冲击性脑损伤影响肺损伤中的作用 注:当大脑受到冲击波的冲击后,全身炎症反应综合征被激活,脑内大量促炎细胞因子的产生会增加神经元的兴奋性,损害细胞,并增加血脑屏障的通透性,当血脑屏障受损时,这些细胞因子进入体循环的释放增加,从而激活炎症级联反应,并扩散到肺部,继而导致免疫抑制和感染。 同时由于冲击波的影响,机体自主神经系统发生紊乱,因此干预迷走神经激活胆碱能α7nAChR 通路,可对肺脏起到抗炎和修复作用;ACh 为乙酰胆碱;α7nAChR 为α7 烟碱型乙酰胆碱受体(该图片使用Figdraw 平台绘制)
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