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内脏脂肪组织在克罗恩病发病、诊断及治疗中的作用

陈博 阳惠湘

陈博, 阳惠湘. 内脏脂肪组织在克罗恩病发病、诊断及治疗中的作用[J]. 协和医学杂志, 2021, 12(1): 73-79. doi: 10.3969/j.issn.1674-9081.2020.00.007
引用本文: 陈博, 阳惠湘. 内脏脂肪组织在克罗恩病发病、诊断及治疗中的作用[J]. 协和医学杂志, 2021, 12(1): 73-79. doi: 10.3969/j.issn.1674-9081.2020.00.007
CHEN Bo, YANG Hui-xiang. The Role of Visceral Adipose Tissue in the Pathogenesis, Diagnosis, and Treatment of Crohn's Disease[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(1): 73-79. doi: 10.3969/j.issn.1674-9081.2020.00.007
Citation: CHEN Bo, YANG Hui-xiang. The Role of Visceral Adipose Tissue in the Pathogenesis, Diagnosis, and Treatment of Crohn's Disease[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(1): 73-79. doi: 10.3969/j.issn.1674-9081.2020.00.007

内脏脂肪组织在克罗恩病发病、诊断及治疗中的作用

doi: 10.3969/j.issn.1674-9081.2020.00.007
基金项目: 

国家自然科学基金 81873585

详细信息
    通讯作者:

    阳惠湘  电话:0731-89753723,E-mail:yang_hx430@163.com

  • 中图分类号: R574

The Role of Visceral Adipose Tissue in the Pathogenesis, Diagnosis, and Treatment of Crohn's Disease

Funds: 

The National Natural Science Foundation of China 81873585

More Information
    Corresponding author: YANG Hui-xiang   Tel: 86-731-89753723, E-mail: yang_hx430@163.com
  • 摘要: 克罗恩病(Crohn's disease,CD)是一种慢性炎性肉芽肿性疾病,多发于末端回肠和临近结肠,呈节段性分布。CD肠道病变的机制尚不完全明确,与遗传、免疫和环境等多种因素有关。脂肪组织在CD的发病中发挥重要作用,最新研究发现内脏脂肪组织(visceral adipose tissue,VAT),特别是其肠系膜成分,亦称为爬行脂肪,可通过免疫调节特性影响CD进程。本文主要综述VAT在CD发病、诊断及治疗中的研究进展,以期为临床诊疗提供理论依据。
    作者贡献:陈博负责收集文献、撰写并修订文章; 阳惠湘负责提出选题思路,修订文章。
    利益冲突  无
  • 图  1  克罗恩病患者的病变肠切除标本[5]显示,增生的肠系膜脂肪组织(箭头)包绕肠管且超过其周长的50%,即“爬行脂肪征”

    图  2  内脏脂肪组织(紫色)的MRI定量分析影像[6]

    A.正常人; B.克罗恩病患者

    图  3  内脏脂肪组织与克罗恩病发病机制、病程及诊断的关系

    VAT:内脏脂肪组织; CRP:C反应蛋白; CD、TNF-α、IL:同表 1

    表  1  与CD相关的主要脂肪因子及功能

    脂肪因子 功能
    瘦素 促进TNF-α的产生,与TNF-α协同发挥促炎作用[13]; 调节辅助T细胞极化,通过记忆T细胞促进幼稚T细胞增殖和干扰素-γ的产生[14]
    脂联素 具有不同的亚型,表现出不同的生物学效应[15]
    抵抗素 由促炎细胞因子(IL-1、IL-6和TNF-α)诱导表达[16]; 通过NF-κB信号通路促进单核细胞表达TNF-α、IL-6和IL-12,发挥促炎活性[17]
    趋化素 通过招募和激活抗原呈递细胞在炎症早期发挥作用,连接先天免疫和获得性免疫[18]; 是促进CD炎症反应的重要因子
    CD:克罗恩病; TNF-α:肿瘤坏死因子-α; IL:白细胞介素; NF-κB:核因子-κB
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出版历程
  • 收稿日期:  2020-05-05
  • 录用日期:  2020-06-08
  • 网络出版日期:  2020-08-11
  • 刊出日期:  2021-01-30

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