放射性肠炎中微血管损伤机制及与内镜表现的关系
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摘要
放射性肠炎内镜下常具有黏膜下毛细血管网减少,残留血管异常扩张等较特征性表现。本文主要介绍放射性肠炎中微血管损伤的机制,包括微血管密度下降、黏膜下纤维化、异常新生血管等与内镜下表现的关系,以期为临床治疗放射性肠炎提供新的思路。
Radiation enteritis always showed characteristic decreased capillary network and abnormal dilated vessels at endoscopy.This article mainly reviewed the mechanism of microvessel damage,including the relationship of decreased microvessel density,submucosal fibrosis,abnormal neovascularization with cytokines and inflammatory mediators.These relationships may provide new idea in treatment of radiation enteritis.
Radiation enteritis always showed characteristic decreased capillary network and abnormal dilated vessels at endoscopy.This article mainly reviewed the mechanism of microvessel damage,including the relationship of decreased microvessel density,submucosal fibrosis,abnormal neovascularization with cytokines and inflammatory mediators.These relationships may provide new idea in treatment of radiation enteritis.
引文
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[13] Wang J,Boerma M,Fu Q,et al.Significance of endothelial dysfunction in the pathogenesis of early and delayed radiation enteropathy[J].World J Gastroenterol,2007,13(22):3047- 3055.
[14] Stansborough RL,Bateman EH,Noor AD,et al.Vascular endothelial growth factor (VEGF),transforming growth factor beta (TGFβ),angiostatin,and endostatin are increased in radiotherapy- induced gastrointestinal toxicity[J].Int J Rad Biol,2018:1- 30.
[15] Charlotte T,B?ck Sven,Lena W,et al.Local radiotherapy of exposed murine small bowel:Apoptosis and inflammation[J].BMC Surgery,2008,8:1.
[2] Chao Y,Dai WM,Chen HX,et al.Application of human bone marrow- derived mesenchymal stem cells in the treatment of radiation- induced Gastrointestinal syndrome[J].Science China Life Sciences,2014,57(12):1177- 1182.
[3] 谢静,李长政.放射性肠炎的内镜特点和治疗[J/CD].中华胃肠内镜电子杂志,2018(3):124- 126.
[4] Slezak J,Kura B,Ravingerová,Táňa,et al.Mechanisms of cardiac radiation injury and potential preventive approaches[J].Can J Physiol Pharmacol,2015:1- 17.
[5] Baker DG,Krochak RJ.The response of the microvascular system to radiation:a review[J].Cancer Invest,1989,7(3):287- 294.
[6] Lee MS,Finch W,Mahmud E.Cardiovascular Complications of Radiotherapy[J].Am J Cardiol,2013,112(10):1688- 1696.
[7] Fran?ois Paris,Fuks Z,Kang A,et al.Endothelial Apoptosis as the Primary Lesion Initiating Intestinal Radiation Damage in Mice[J].Science,2001,293(5528):293- 297.
[8] Baker JE,Fish BL,Su J,et al.10 Gy total body irradiation increases risk of coronary sclerosis,degeneration of heart structure and function in a rat model[J].Int J Rad Biol,2009,85(12):1089- 1100.
[9] Stewart FA,Hoving S,Russell NS.Vascular Damage as an Underlying Mechanism of Cardiac and Cerebral Toxicity in Irradiated Cancer Patients[J].Rad Res,2010,174(6b):865- 869.
[10] Kawano S,Kubota T,Monden Y,et al.Blockade of NF- kappa B improves cardiac function and survival after myocardial infarction[J].Am J Physiol Heart Circ Physiol,2006,291(3):H1337.
[11] Sbragia L,Schmidt AF,Moraes S,et al.Inflammatory response in a rat model of gastroschisis is associated with an increase of NF- kappaB[J].Br J Med Biol Res,2010,43(2):160- 165.
[12] Beenken A,Mohammadi M.The FGF family:biology,pathophysiology and therapy[J].Nat Rev Drug Discov,2009,8(3):235- 253.
[13] Wang J,Boerma M,Fu Q,et al.Significance of endothelial dysfunction in the pathogenesis of early and delayed radiation enteropathy[J].World J Gastroenterol,2007,13(22):3047- 3055.
[14] Stansborough RL,Bateman EH,Noor AD,et al.Vascular endothelial growth factor (VEGF),transforming growth factor beta (TGFβ),angiostatin,and endostatin are increased in radiotherapy- induced gastrointestinal toxicity[J].Int J Rad Biol,2018:1- 30.
[15] Charlotte T,B?ck Sven,Lena W,et al.Local radiotherapy of exposed murine small bowel:Apoptosis and inflammation[J].BMC Surgery,2008,8:1.