整合素在肝纤维化中的作用:从机制到治疗
DOI: 10.12449/JCH251227
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摘要: 肝纤维化是慢性肝病发展至肝硬化的关键阶段,以细胞外基质(ECM)过度沉积为主要特征。整合素(包含α和β亚基)作为细胞与ECM相互作用的关键分子,参与细胞黏附、信号传导和细胞迁移等过程,在肝纤维化中发挥重要作用。在肝纤维化进程中,整合素的表达上调,通过与ECM的相互作用促进肝星状细胞的活化和增殖,加速ECM的合成和沉积。其中,整合素αVβ3和αVβ6在肝纤维化中的表达增加尤为显著,与TGF-β信号通路的激活密切相关。此外,整合素还与炎症反应和肝脏再生修复过程相关。整合素作为治疗靶点具有巨大潜力,针对整合素的抑制剂有望为肝纤维化提供新的治疗策略。Abstract: Liver fibrosis is a key pathological stage in the progression of chronic liver diseases to liver cirrhosis and is characterized by excessive extracellular matrix (ECM) deposition. As critical mediators of cell-ECM crosstalk, integrins play an important role in the development and progression of liver fibrosis. The integrin family includes α and β subunits and is widely involved in the regulation of cell adhesion, migration, and signal transduction. In the process of liver fibrosis, the expression of integrins is upregulated, and its interaction with ECM promotes the activation and proliferation of hepatic stellate cells, further accelerating the synthesis and deposition of ECM. The increases in the expression of integrins αVβ3 and αVβ6 are closely associated with the activation of the TGF-β signaling pathway. In addition, integrins also modulate inflammatory responses and tissue regeneration and repair in the liver. Based on the above mechanisms, integrins have become the potential targets for the treatment of liver fibrosis, and inhibitors targeting integrins may become a new strategy for the treatment of liver fibrosis.
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Key words:
- Liver Fibrosis /
- Integrins /
- Hepatic Stellate Cells /
- Therapeutics
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表 1 肝纤维化治疗中整合素相关靶点药物
Table 1. Integrin-related target drugs in the treatment of liver fibrosis
药物 靶点 机制 临床试验阶段 Abituzumab[38-42] 整合素αV 拮抗整合素αV 未开展 intetumumab[38-42] 整合素αV 拮抗整合素αV 未开展 cilengitide[38-42] 整合素αV 拮抗整合素αV 未开展 BG00011[38-42] 整合素αV 拮抗整合素αV 未开展 MK-0429[38-42] 整合素αV 拮抗整合素αV 未开展 CWHM-12[43] 整合素αV 拮抗整合素αV 肝硬化临床前 PLN-1474[45] 整合素αVβ1 拮抗整合素αV和整合素β1 非酒精性脂肪性肝炎
和肝硬化临床Ⅰ期PLN-74809[44] 整合素αVβ1;
整合素αVβ6拮抗整合素αV和整合素β1;
拮抗整合素αV和整合素β6硬化性胆管炎临床
Ⅱ期cRGDyK[46] 整合素αVβ3 基于整合素αVβ3的纳米粒子cRGDyK引导的脂质小
体靶向活化的HSC并缓解肝纤维化未开展 miR-190b-5p[47] 整合素α6 靶向透明质合酶2和整合素α6治疗肝纤维化 未开展 miR-296-3p[47] 整合素α6 靶向透明质合酶2和整合素α6治疗肝纤维化 未开展 扶正化瘀方[48-49] 整合素α5β1 拮抗整合素α5和整合素β1;
抑制纤维连接蛋白刺激的HSC增殖活化,下调整合素/
FAK信号通路未开展 肝复康[50] 整合素α5β1 抑制整合素α5β1/FAK通路 未开展 灵芝多糖[51] 整合素α6;
整合素α8减少整合素α6和整合素α8表达,通过TLR4/NF-κB/
MyD88信号通路抑制肝纤维化和炎症未开展 XHH2[52] 整合素β1 干扰Gal-3/整合素β1/FAK通路失活HSC,减轻肝损伤
和肝纤维化未开展 蒙古山萝卜花总黄
酮提取物[53]整合素β4 抑制整合素β4/FAK/p38通路,抑制HSC-T6细胞活化、
增殖,促进凋亡未开展 -
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