【摘要】 动脉粥样硬化的发生和发展主要由局部血管壁炎症和脂质积累引发。巨噬细胞在病灶演变中发挥着核心作用。在动脉粥样硬化病变中，巨噬细胞受到各种各样的微环境信号调节，如细胞因子、氧化脂质、亚铁血红素等，从而导致其表型极化。目前已证实巨噬细胞表型谱主要由T辅助细胞1(Th-1)细胞因子诱导的M1型和由Th-2细胞因子诱导的M2型为主，其中M2型又细分为M2a、M2b、M2c、M2d，此外尚有Mox型、M4型、M(Hb)和Mhem型。对巨噬细胞表型可塑性机制的研究成为制定抑制或稳定动脉粥样硬化斑块治疗策略的重要内容。近年来，社会心理因素在动脉粥样硬化发生发展中的作用已成为研究的热点。慢性心理应激时交感肾上腺髓质(SAM)系统和下丘脑-垂体-肾上腺轴(HPA)的持续激活导致儿茶酚胺类激素和糖皮质激素分泌显著增加，它们对巨噬细胞表型可塑性的调节和功能后果产生重要影响。该文对动脉粥样硬化斑块中巨噬细胞亚群的特征，及在多种组织中神经内分泌激素如儿茶酚胺类激素和糖皮质激素对巨噬细胞表型可塑性的影响进行综述。更多还原

【Abstract】 The initiation and progression of atherosclerosis are mainly caused by inflammation and lipid accumulation in the local vascular. Macrophages play a central role in the development and progression of lesions. In the atherosclerotic lesions,macrophages are regulated by a variety of microenvironmental factors,such as cytokines,oxidized lipids,and heme iron,which effect the phenotypic polarization. Nowadays,it has been confirmed that the macrophage phenotype spectrum is characterized mainly classical M1 macrophages induced by T-helper 1( Th-1) cytokines and by the alternative M2 macrophages induced by Th-2 cytokines,of which M2 macrophages can be further classified into M2 a,M2 b,M2 c and M2 d subtypes. And atherosclerotic plaque-specific macrophage phenotypes include M4 type,M( Hb) or Mhem type,Mox type. Studying the mechanism of macrophage phenotypic plasticity has become an important work to exploit new way to inhibit and stabilize atherosclerosis. In recent years,the effects of social psychological factors on the development of AS have become a hot topic. The continuous activation of the sympathetic adrenal medulla( SAM) system and the hypothalamic-pituitary-adrenal axis( HPA) during psychosocial stress leads to a significant increase in the secretion of catecholamines and glucocorticoids,which play an important role in the regulation of macrophage phenotypic plasticity and its functional consequences. This review summarizes the knowledge of macrophage subsets in atherosclerotic plaques and the influence of neuroendocrine hormones such as catecholamines and glucocorticoids on the phenotypic plasticity of macrophages in various tissues.更多还原