基于中医“痰瘀理论”,龙华医院王拥军、梁倩倩研究团队首先提出淋巴系统是治疗出血性疾病的潜在靶点

2020-06-24 龙华医院 龙华医院

首先提出淋巴系统是治疗出血性疾病的潜在靶点,揭示硬脑膜淋巴系统在清除蛛网膜下腔出血的红细胞过程发挥重要作用。

 

近日,我院王拥军教授、梁倩倩研究员(通讯作者)带领陈锦漫博士(第一作者)等团队成员,在《Nature Communications》(IF:11.878)杂志发表了题为“Meningeal lymphatics clear erythrocytes that arise from subarachnoid hemorrhage”的研究文章,首先提出淋巴系统是治疗出血性疾病的潜在靶点,揭示硬脑膜淋巴系统在清除蛛网膜下腔出血的红细胞过程发挥重要作用。

出血是一种常见的病理现象,但是至今为止,出血后血细胞的清除机制仍然不是十分清楚。淋巴管系统具有回流大分子蛋白和免疫细胞的作用,但是,淋巴管系统是否参与血细胞的清除过程仍是未解之谜。蛛网膜下腔出血是引起脑底部或脑、脊髓表面的血管发生破裂、血液直接流入蛛网膜下腔引起的急性综合征,临床表现为剧烈头痛、呕吐、脑膜刺激征和血性脑脊液。其发生年龄早、死亡率和致残率高、且临床预后差。因此,清除血细胞可能有助于减轻蛛网膜下腔出血造成的病理损伤。硬脑膜淋巴管表达淋巴管内皮细胞所表达的表面抗原,具有回流脑脊液中的大分子物质及免疫细胞到颈部淋巴结、参与中枢神经系统免疫调节等功能。但硬脑膜淋巴管是否可以回流脑脊液中的红细胞尚不清楚。

王拥军和梁倩倩研究团队在中医“痰瘀理论”指导下,结合施杞教授治疗脑外伤的临床经验,在国内率先建立了ICG-NIR活体动态检测淋巴回流、小动物超声、全片扫描免疫荧光染色检测淋巴管分布等技术,并形成了以淋巴系统结构与功能评价出炎症性疾病、免疫性疾病、出血性疾病的方法学体系,证明淋巴系统在出血性疾病发生发展过程中发挥重要作用。本研究通过体内实验证实,在蛛网膜下腔出血4个小时后,颈深和下颌下淋巴结、及硬脑膜淋巴管聚集了大量红细胞。破坏硬脑膜淋巴管后,再造蛛网膜下腔出血模型,发现红细胞在颈深淋巴结和下颌下淋巴结中的数量降低,而蛛网膜下腔出血引起的神经炎症和神经功能缺损则加重。此外,在蛛网膜下腔出血后,脑淋巴回流加快,但未见明显的淋巴管新生和扩张。这项工作表明,在蛛网膜下腔出血后,脑膜淋巴管将脑脊液中的红细胞回流到颈部淋巴结,可以减轻出血造成的脑部损伤。该研究不仅提示硬脑膜淋巴管可能是蛛网膜下腔出血潜在的治疗靶点,而且提示淋巴管系统很可能参与了出血性疾病的发生发展过程,调控淋巴管系统功能可能有助于治疗出血性疾病。该文有助于建立“痰瘀理论”新的研究体系,丰富和发展中医“气血理论”和“津液理论”。

该文章得到国家自然科学基金优秀青年科学基金、国家自然科学基金重点项目以及国家自然科学基金重点国际合作项目(81822050、81904227、81920108032)、国家重点研究发展计划(2018YFC1704300)大力支持。

原始出处:

Chen, J., Wang, L., Xu, H. et al. Meningeal lymphatics clear erythrocytes that arise from subarachnoid hemorrhage. Nat Commun 11, 3159 (2020). http://dx.doi.org/10.1038/s41467-020-16851-z

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    2020-06-24 运动yd

    中医中药,大多被人诋毁,不过梅斯里总是客观公正的

    0

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    2020-06-24 lovetcm

    #中医#中医界的骄傲。

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