慢性鼻窦炎发病机制中代谢重编程

摘要/Abstract

摘要： 慢性鼻窦炎(Chronic rhinosinusitis, CRS)是发生在鼻窦黏膜的慢性炎性疾病,发病机制复杂,与解剖结构、环境和细胞免疫反应多种因素相关。代谢重编程是指细胞为满足自身要求而改变原有的代谢途径的过程,常发生于糖、脂、氨基酸等基础物质代谢途径中。CRS的免疫反应由鼻黏膜上皮细胞及多种免疫细胞共同完成,在嗜酸性粒细胞与非嗜酸性粒细胞CRS中表现为不同的免疫应答,并发生不同途径的代谢紊乱。当细胞受到炎症刺激时,会在发生免疫应答同时出现代谢重编程。细胞代谢途径的改变直接影响细胞功能和炎症因子的分泌,成为CRS发生和发展的关键因素。随着检测技术发展,通过代谢组学等方法检测样本中小分子物质可确定异常代谢途径。分析细胞中的代谢变化已成为研究CRS发病机制和开发新的治疗策略有效手段。本文综述了国内外关于慢性鼻窦炎发病过程中代谢紊乱的相关研究,列举了不同内型CRS的代谢途径,分析代谢重编程与CRS免疫应答的关系并探讨靶向代谢途径紊乱在治疗CRS中的潜在应用。

关键词: 慢性鼻窦炎, 代谢重编程, 代谢组学, 免疫反应, 综述

Abstract: Chronic rhinosinusitis(CRS)is a chronic inflammatory condition of the sinonasal mucosa, characterized by a complex pathogenesis involving anatomical, environmental, and immunological factors. Metabolic reprogramming, the process of altering metabolic pathways to meet cellular functional demands, frequently involves the metabolism of glucose, lipids and amino acids. The immune response in CRS, orchestrated by sinonasal epithelial cells and various immune cells, exhibits distinct immunological responses and associated metabolic dysregulation in eosinophilic and noneosinophilic CRS. When cells are exposed to inflammatory stimuli, they undergo metabolic reprogramming concurrently with activation of immune signaling. These alterations in metabolic pathways directly influence cellular function and cytokine secretion, representing critical factors in the onset and progression of CRS. With advancements in detection technologies, methods such as metabolomics can identify aberrant metabolic pathways by analysing metabolites.The analysis of cellular metabolic changes has thus become an effective approach for studying the pathogenesis of CRS and developing new therapeutic strategies. This article reviews recent global progress on metabolic dysregulation in CRS pathogenesis, enumerates the metabolic pathways of different CRS endotypes, analyses the relationship between metabolic reprogramming and the immune response, and explores the potential application of targeting dysregulated metabolic pathways in CRS therapy.

Key words: Chronic rhinosinusitis, Metabolic reprogramming, Metabolomics, Immune response, Review

中图分类号:

R765.4

吴玉洁,朱晓燕,王旭. 慢性鼻窦炎发病机制中代谢重编程[J]. 山东大学耳鼻喉眼学报, 2026, 40(6): 91-99.

WU Yujie, ZHU Xiaoyan, WANG Xu. Metabolic reprogramming in the pathogenesis of chronic rhinosinusitis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(6): 91-99.

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