The balance of HGF and TGF-β1 in the remodeling of chronic rhinosinusitis
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摘要: 慢性鼻窦炎(chronic rhinosinusitis,CRS)常常表现为鼻腔及鼻窦黏膜长达3个月以上的的慢性持续性炎症,是耳鼻咽喉头颈外科常见的健康问题。其患病率高,经过规范化药物治疗后的复发及手术治疗后的并发症使其临床疗效未令人满意。长期慢性炎症的刺激下,CRS组织重塑是不可避免的结果,并最终导致了黏膜组织结构及功能的改变。组织结构改变往往难以逆转,给疾病治疗增加难度,与此同时导致疾病进一步慢性化及难治化。CRS组织重塑的机制至今尚未完全明确,被认为是多因素共同调控产生的结果。细胞因子在慢性鼻窦炎炎症及重塑过程中起关键作用。目前很多细胞因子被证实与CRS组织重塑存在密切相关性,其中转化生长因子-beta1(transforming growth factor-beta1,TGF-β1)研究最火热,其被公认为致纤维化最强的因子,参与调控多器官组织重塑。TGF-β1已被证实在慢性鼻窦炎炎症及重塑机制中起着不可或缺的作用。肝细胞生长因子(hepatocyte growth factor,HGF)通过与其受体c-Met结合在多个细胞及组织中发挥各种生物学效应,已被证实能影响TGF-β1的表达以及具有抗纤维化作用,HGF/TGF-beta1的平衡在CRS组织重塑中有着关键的调节作用。本文综述了2个因子及其平衡在CRS组织重塑机制中所起作用和现有研究成果。Abstract: Chronic rhinosinusitis (CRS) often presents as the inflammation of the nose cavity and the mucous membrane lining of the sinuses for up to three months.Meanwhile CRS is a common health problem of otorhinolaryngology-head and neck surgery,it has a high prevalence rate that leads the treatment unsatisfactory for most of patients in the clinical efficacy with the effects of the recurrence of the drug treatment and the complications after surgical treatment.Due to the long-term chronic inflammation stimulation,the remodeling of CRS is an inevitable result and eventually leads to the changes in mucosal structure and function.The changes of mucosal structure is hard to be irreversible,thus this increases the difficulty of the treatment,at the same time leads to chronic and refractory of disease further.The remodeling of CRS has not yet been clearly defined in the studies of the medical community,which is considered to be a result of the combination of various factors.Cytokines play vital role in the process of inflammation and remodeling processes in CRS,so far multiple cytokines have been found to be closely related to the remodeling of CRS,one of cytokines with the hottest study is called as Transforming growth factor-beta1(TGF-β1),that is commonly recognized as the strongest factor in the fibrosis,involved in the regulation of remodeling processes of multiple organ tissue.TGF-β1 has been demonstrated as an indispensable role in remodeling processes in CRS,and Hepatocyte growth factor (HGF) exerts various biological effects in multiple cells and tissues by binding to its receptor c-Met.TGF-beta1 has been demonstrated as a crucial regulatory factor in this process in CRS as well.Furthermore,(HGF) can affect the expression of TGF-beta1 and play a role in anti-fibrosis.The balance of HGF and TGF-beta 1 plays a key role in regulating in CRS.This review aims to summarize the current findings on the mechanisms of two factors in CRS,so as to state the role of TGF-beta1 and HGF in the regulation of remodeling.
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Key words:
- Chronic rhinosinusitis /
- Remodeling /
- TGF-β1 /
- HGF
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