心肌缺血再灌注损伤(myocardial ischemia/reperfusion injury,MI/RI)是影响急性心肌梗死患者接受再灌注治疗临床预后的主要因素,其发生机制尚未完全明确,且缺乏有效防治手段.为解决这一科学难题,前蛋白转化酶枯草溶菌素9(proprotein convertase subtilisin/kexin type 9,PCSK9)的多重作用被发掘出来,其除了发挥众所周知的调节脂质代谢的作用以外,还与MI/RI的发生发展密切相关.PCSK9的下调有利于减弱受损心肌的内源性凋亡途径和自噬性死亡途径,降低细胞氧化应激以及炎症反应,拮抗心律失常的发生,提示PCSK9可能是MI/RI的潜在干预靶点.本文对PCSK9在MI/RI中的作用及机制作一综述,有望为深入研究MI/RI的临床防治提供治疗策略和理论依据.
The role of PCSK9 in myocardial ischemia-reperfusion injury
Myocardial ischemia-reperfusion injury(MI/RI)is the main factor affecting the clinical prognosis of patients with acute myocardial infarction receiving reperfusion therapy,its mechanism is not completely clear while there is a lack of effective prevention and treatment methods.In order to solve this scientific problem,the multiple roles of proprotein convertase subtilisin/kexin type 9(PCSK9)have been explored.It has been found that in addition to its well-known role in regulating lipid metabolism,PCSK9 is also closely related to the occurrence and development of MI/RI.Down-regulation of PCSK9 is beneficial to attenuate the endogenous apoptosis pathway and autophagic death pathway of the damaged myocardium,reduce oxidative stress and inflammatory response,and antagonize the occurrence of arrhythmia,suggesting that PCSK9 may be a potential intervention target for MI/RI.This paper reviews the role and mechanism of PCSK9 in MI/RI,is expected to provide therapeutic strategies and theoretical basis for further research on the clinical prevention and treatment of MI/RI.
PCSK9myocardial ischemiareperfusion injuryapoptosis of cellsautophagyoxidative stressinflammatory responsecardiac electrical activity
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维普
