补体系统在冠状动脉粥样硬化中的作用

摘要

冠状动脉粥样硬化(CAS)近年被普遍认为是慢性炎症性病变,补体系统作为固有免疫的重要组分在CAS发病机制中有重要作用.斑块中的多种组分可以激活补体分子,同时补体系统的激活又反过来促进斑块病变进展.但是,近年研究也发现补体系统的某些保护作用,使得对补体系统与CAS的关系有了更全面的认识.除了上述的直接作用,补体系统还可以通过参与血小板活化、代谢综合征等CAS相关病变过程间接促进CAS的发展.临床研究证实,循环中补体分子的水平可以预测CAS的发病风险、不稳定斑块和CAS患者的临床预后,预示补体分子可能成为非常有潜力的临床预测指标.本文主要介绍了斑块中补体分子的来源、激活及其在CAS发生发展中的作用机制,并总结了补体分子作为潜在预测指标的临床价值.%Coronary atherosclerosis (CAS) has been recognized as a chronic inflammatory disease in recent years.As an important component of innate immunity,complement system plays an important role in the pathogenesis of CAS.Multiple components of plaque can activate complement proteins,and the activation of complement promotes the progression of plaque lesions in turn.However,recent studies have also found that some proteins of the complement system may also paly an atheroprotective role in the early stage of atherosclerosis.In addition to the direct effects,complement system is also involved in CAS-related pathological changes.Complement proteins may be promising biomarkers,as confirmed by clinical studies which suggest that circulation levels of some complement proteins can predict the risk and prognosis of CAS.This review mainly introduced the origin and activation of complement molecules inside the plaques,their important roles in the pathogenesis of CAS,and the value of complement molecules as potential predictors in clinical.