Role of various imbalances centered on alveolar epithelial cell/fibroblast apoptosis imbalance in the pathogenesis of idiopathic pulmonary fibrosis

作     者：Qing Wang Zhao-Liang Xie Qi Wu Zhi-Xian Jin Chao Yang Jing Feng Wang Qing;Xie Zhao-Liang;Wu Qi;Jin Zhi-Xian;Yang Chao;Feng Jing

作者机构：Department of Respiratory and Critical Care Medicine of Kunming Municipal First People’s HospitalKunmingYunnan 650000China Graduate SchoolTianjin Medical UniversityTianjin 300070China Respiratory Department of Sanming Yongan General HospitalSanmingFujian 366000China Medical SchoolTianjin University SchoolTianjin 300072China Department of Respiratory and Critical Care MedicineTianjin Medical University General HospitalTianjin 300052China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2021年第134卷第3期

页      面：261-274页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

基　　金：National Natural Science Foundation of China(No.81970083)。 

主　　题：Alveolar epithelial cell Apoptosis Idiopathic pulmonary fibrosis Fibroblast Pathogenesis 

摘      要：There have been recent extensive studies and rapid advancement on the pathogenesis underlying idiopathic pulmonary fibrosis(IPF),and intricate pathogenesis of IPF has been suggested.The purpose of this study was to clarify the logical relationship between these mechanisms.An extensive search was undertaken of the PubMed using the following keywords:etiology,pathogenesis,alveolar epithelial cell(AEC),fibroblast,lymphocyte,macrophage,epigenomics,histone,acetylation,methylation,endoplasmic reticulum stress,mitochondrial dysfunction,telomerase,proteases,plasminogen,epithelial-mesenchymal transition,oxidative stress,inflammation,apoptosis,andidiopathic pulmonary fibrosis.This search covered relevant research articles published up to April 30,2020.Original articles,reviews,and other articles were searched and reviewed for content;240 highly relevant studies were obtained after screening.IPF is likely the result of complex interactions between environmental,genetic,and epigenetic factors:environmental exposures affect epigenetic marks;epigenetic processes translate environmental exposures into the regulation of chromatin;epigenetic processes shape gene expression profiles;in turn,an individual’s genetic background determines epigenetic marks;finally,these genetic and epigenetic factors act in concert to dysregulate gene expression in IPF lung tissue.The pathogenesis of IPF involves various imbalances including endoplasmic reticulum,telomere length homeostasis,mitochondrial dysfunction,oxidant/antioxidant imbalance,Th1/Th2 imbalance,M1-M2 polarization of macrophages,protease/antiprotease imbalance,and plasminogen activation/inhibition imbalance.These affect each other,promote each other,and ultimately promote AEC/fibroblast apoptosis imbalance directly or indirectly.Excessive AEC apoptosis and impaired apoptosis of fibroblasts contribute to fibrosis.IPF is likely the result of complex interactions between environmental,genetic,and epigenetic factors.The pathogenesis of IPF involves various imbalances centered on AEC/fibroblast apoptosis imbalance.