GM-CSF在重症病毒感染相关细胞因子风暴中的作用及干预

Role of GM-CSF in severe viral infection-associated cytokine storm and therapeutic interventions

  • 摘要: 病毒感染相关细胞因子风暴与重症患者不良预后密切相关,病毒入侵后,粒细胞-巨噬细胞集落刺激因子(GM-CSF)在病理状态下异常上调,通过激活磷脂酰肌醇3-激酶-蛋白激酶B信号通路(PI3K-AKT)、丝裂原活化蛋白激酶-细胞外信号调节激酶信号通路(MAPK-ERK)、核因子κB信号通路(NF-κB)及Janus激酶-信号转导子和转录激活子信号通路(JAK-STAT)等多条信号通路导致细胞因子风暴。除直接感染外,病毒还可通过结合特定受体促进复制,而心理应激、合并感染等因素进一步加剧炎症。GM-CSF与其他细胞因子的协同作用可放大全身炎症反应。针对GM-CSF及其下游通路的靶向治疗具有潜在临床干预价值。值得注意的是,GM-CSF的信号调控也直接影响巨噬细胞极化,因此, 诱导其向M2表型极化可能成为未来抗炎治疗的新策略。

     

    Abstract: The viral infection-associated cytokine storm is closely associated with the poor prognosis of the critical patients, the granulocyte-macrophage colony-stimulating factor(GM-CSF) is abnormally upregulated under pathological state after viral invasion, which then may result in cytokine storm by activating multiple signaling pathways such as phosphatidylinositol 3-kinase (PI3K)-AKT signaling pathway (PI3K-AKT), mitogen-activated protein kinase-extracellular signal-regulated kinase (MAPK-ERK) signaling pathway, nuclear factor κB (NF-κB) signaling pathway and Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling pathway. In addition to the direct infection, viral binding to specific receptors enhances the replication, with factors like psychological stress and co-infections exacerbating the inflammation. GM-CSF synergizes with other cytokines to amplify the systemic inflammatory responses. The targeting GM-CSF and the targeted therapy of its downstream pathways have potential value of clinical intervention. Notably, the GM-CSF signal regulating also has direct impact on the macrophage polarization, therefore, promoting a shift to the M2 phenotype polarization represents a promising anti-inflammatory strategy.

     

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