The research progress of the effect of cholinergic α7nAChR pathway on pulmonary function after plateau blast brain injury
Liu Xingqing1, Meng Xiangyang1, Li Sen2, Wang Haiyan2, Xie Youhong1, Yang Ce2.
1Rehabilitation Hospital of Chongqing Medical University, Chongqing 400050, China; 2National Key Laboratory of Trauma and Chemical Poisoning, Department of Field Surgery, Daping Hospital, Army Medical University, Chongqing 400042, China
Abstract:The plateau region, with its unique geographical environment and climatic conditions, has a significant impact on human health. Especially its low oxygen and low air pressure increases the incidence and severity of traumatic brain injury. As the core organ of gas exchange, the function of the lungs is vulnerable to damage in the plateau environment, which in turn exacerbates pulmonary infection after traumatic brain injury and increases mortality rate. This is manifested through pathological changes such as inflammation, edema, and hemorrhage, potentially leading to severe complications such as acute respiratory distress syndrome and neurogenic pulmonary edema. There exists a complex bidirectional functional interaction and information transmission between the brain and lungs. The vagus nerve, as a key neural pathway connecting the brain and the lungs, has an important impact on lung injury by regulating inflammatory responses, vascular permeability and other processes through the cholinergic anti-inflammatory pathway (CAP). Among these, α7 nicotinic acetylcholine receptor (α7nAChR) is a fundamental component of the CAP pathway. The nucleus tractus solitarius (NTS), a key node of the CAP pathway, receives sensory inputs from the lungs via the vagus nerve. The NTS processes and integrates these information, sending signals to other brainstem and forebrain regions to elicit vagal impulses to release acetylcholine delivery to peripheral tissues and organs. This regulate the autonomic nervous system and cardiorespiratory function, exerting anti-inflammatory effects. Therefore, this paper systematically reviews the effects of traumatic brain injury on lung function and the protective role of the cholinergic α7nAChR pathway, providing scientific evidence and strategic insights for the prevention and treatment of plateau impact injuries.
刘兴庆 孟祥洋 李森 王海燕 谢友红 杨策. 胆碱能α7烟碱型乙酰胆碱受体通路对高原冲击性脑损伤后肺脏功能的影响研究进展[J]. 中华诊断学电子杂志, 2025, 13(1): 65-70.
Liu Xingqing1, Meng Xiangyang1, Li Sen2, Wang Haiyan2, Xie Youhong1, Yang Ce2.. The research progress of the effect of cholinergic α7nAChR pathway on pulmonary function after plateau blast brain injury. zhzdx, 2025, 13(1): 65-70.
[1]Okidi R,Ogwang DM,Okello TR,et al.Factors affecting mortality after traumatic brain injury in a resource-poor setting[J].BJS Open,2020,4(2):320-325.DOI:10.1002/bjs5.50243.
[2]张慧敏,向科发,史小飞,等.胆碱能抗炎通路α7烟碱型乙酰胆碱受体的最新研究进展[J].药学实践与服务,2022,40(6):485-493.DOI:10.12206/j.issn.2097-2024.202204037.
[3]秦雨涵,侯宏卫,胡清源.α7烟碱型乙酰胆碱受体在胆碱能抗炎通路中的作用机制及应用现状[J].中国生物化学与分子生物学报,2022,38(10):1304-1310.DOI:10.13865/j.cnki.cjbmb.2022.04.1532.
[4]李晓炎,宁心,杨志焕,等.高原与平原冲击波物理参数和生物效应的比较研究[J].中国危重病急救医学,2005,17(2):102-104.DOI:10.3760/j.issn:1003-0603.2005.02.012.
[5]杨志焕,李晓炎,朱佩芳,等.高原冲击伤的损伤特点研究[J].西南国防医药,2003,13(1):3-6.DOI:10.3969/j.issn.1004-0188.2003.01.002.
[6]王峰,杨志焕,朱佩芳,等.高原冲击伤伤情特点的实验研究[J].创伤外科杂志,2008,10(6):549-551.DOI:10.3969/j.issn.1009-4237.2008.06.026.
[7]刘凤英,马海英.高原环境脑损伤与药物治疗研究进展[J].国际药学研究杂志,2019,46(6):418-422.DOI:10.13220/j.cnki.jipr.2019.06.003.
[8]邹鹏,蒋晓帆,罗鹏,等.高原低氧环境中的颅脑损伤患者继发性脑损伤发病机制研究进展[J].山东医药,2023,63(3):101-104.DOI:10.3969/j.issn.1002-266X.2023.03.024.
[9]许常林,吴彬杰,马西坤,等.高原环境对大鼠脑损伤局部炎性反应的影响[J].高原医学杂志,2019,29(3):5-8.DOI:10.3969/j.issn.1007-3809.2019.03.002.
[10]王建民,王正国,朱佩芳,等.爆炸冲击波对肺微血管内皮细胞损伤作用的病理学观察[J].微循环学杂志,2001,11(3):4-6.DOI:10.3969/j.issn.1005-1740.2001.03.002.
[11]Stevens RD,Puybasset L.The brain-lung-brain axis[J].Intensive Care Med,2011,37(7):1054-1056.DOI:10.1007/s00134-011-2233-1.
[12]Fan L, Xiang B, Xiong J, et al. Use of viruses for interrogating viscera-specific projections in central nervous system[J].J Neurosci Methods,2020(341):108757.DOI:10.1016/j.jneumeth.2020.108757.
[13]Feng M,Xiang B,Fan L,et al.Interrogating autonomic peripheral nervous system neurons with viruses-a literature review[J].J Neurosci Methods,2020(346):108958.DOI:10.1016/j.jneumeth.2020.108958.
[14]Bulfamante G,Bocci T,Falleni M,et al.Brainstem neuropathology in two cases of COVID-19:SARS-CoV-2 trafficking between brain and lung[J].J Neurol,2021,268(12):4486-4491.DOI:10.1007/s00415-021-10604-8.
[15]Li C,Chen W,Lin F,et al.Functional two-way crosstalk between brain and lung:the brain-lung axis[J].Cell Mol Neurobiol,2023,43(3):991-1003.DOI:10.1007/s10571-022-01238-z.
[16]Zoccal DB,Furuya WI,Bassi M,et al.The nucleus of the solitary tract and the coordination of respiratory and sympathetic activities[J].Front Physiol,2014(5):238.DOI:10.3389/fphys.2014.00238.
[17]Wang Y,Zhang J,Zhai W,et al.Current status and prospect of transcutaneous auricular vagus nerve stimulation for disorders of consciousness[J].Front Neurosci,2023(17):1274432.DOI:10.3389/fnins.2023.1274432.
[18]dos Santos CC,Shan Y,Akram A,et al.Neuroimmune regulation of ventilator-induced lung injury[J].Am J Respir Crit Care Med,2011,183(4):471-482.DOI:10.1164/rccm.201002-0314OC.
[19]Chen M,Jiao Y,Shi Y,et al.The rostral ventromedial and lateral medulla are the major areas responsive to lung cancer progression among brainstem lung-innervating nuclei[J].Brain Sci,2022,12(11):1486.DOI:10.3390/brainsci12111486.
[20]Tracey KJ.The inflammatory reflex[J].Nature,2002,420(6917):853-859.DOI:10.1038/nature01321.
[21]Borovikova LV,Ivanova S,Zhang M,et al.Vagus nerve stimulation attenuates the systemic inflammatory response to endotoxin[J].Nature,2000,405(6785):458-462.DOI:10.1038/35013070.
[22]Wu YJ, Wang L, Ji CF, et al. The role of α7nAChR-mediated cholinergic anti-inflammatory pathway in immune cells[J].Inflammation,2021,44(3):821-834.DOI:10.1007/s10753-020-01396-6.
[23]Hofmann GC,Gama de Barcellos Filho P,Khodadadi F,et al.Vagotomy blunts cardiorespiratory responses to vagal afferent stimulation via pre- and postsynaptic effects in the nucleus tractus solitarii[J].J Physiol,2024,602(6):1147-1174.DOI:10.1113/JP285854.
[24]马莉,冷玉芳,张梦婕,等.胆碱能抗炎通路对器官的保护研究进展[J].兰州大学学报(医学版),2020,46(1):10-15.DOI:10.13885/j.issn.1000-2812.2020.01.003.
[25]Millar NS.Assembly and subunit diversity of nicotinic acetylcholine receptors[J].Biochem Soc Trans,2003,31(Pt 4):869-874.DOI:10.1042/bst0310869.
[26]Schedel A,Thornton S,Schloss P,et al.Human platelets express functional alpha7-nicotinic acetylcholine receptors[J].Arterioscler Thromb Vasc Biol,2011,31(4):928-934.DOI:10.1161/ATVBAHA.110.218297.
[27]Zhao X,Yu Z,Lv Z,et al.Activation of alpha-7 nicotinic acetylcholine receptors (α7nAchR) promotes the protective autophagy in LPS-Induced acute lung injury (ALI) in vitro and in vivo[J].Inflammation,2019,42(6):2236-2245.DOI:10.1007/s10753-019-01088-w.
[28]Pinheiro NM, Banzato R, Tibério I, et al. Acute lung injury in cholinergic-deficient mice supports anti-inflammatory role of α7 nicotinic acetylcholine receptor[J].Int J Mol Sci,2021,22(14):7552.DOI:10.3390/ijms22147552.
[29]张昊,苏乾,史佳,等.电针通过NLRP3/caspase-1通路介导的细胞焦亡途径减轻脓毒症大鼠急性肺损伤[J].中国中西医结合外科杂志,2023,29(6):814-818.DOI:10.3969/j.issn.1007-6948.2023.06.017.
[30]Huang Y,Dong S,Li X,et al.VNS-mediated α7nAChR signaling promotes SPM synthesis via regulation of netrin-1 expression during LPS-induced ALI[J].FASEB J,2024,38(1):e9664.DOI:10.1096/fj.202301623R.
[31]王静.胆碱能抗炎通路调节肺泡巨噬细胞极化减轻急性肺损伤的机制研究[D].武汉:武汉大学,2018.
[32]Chen X,Zhang C,Wei T,et al.α7nAChR activation in AT2 cells promotes alveolar regeneration through WNT7B signaling in acute lung injury[J].JCI Insight,2023,8(15):e162547.DOI:10.1172/jci.insight.162547.
[33]Xie J,Li X,Zhang L,et al.Genistein-3'-sodium sulfonate ameliorates cerebral ischemia injuries by blocking neuroinflammation through the α7nAChR-JAK2/STAT3 signaling pathway in rats[J].Phytomedicine,2021(93):153745.DOI:10.1016/j.phymed.2021.153745.
[34]钟玲,宋永斌,徐建春,等.急性低压低氧对小鼠学习记忆及海马ACh水平、磷酸化tau蛋白表达的影响[J].安徽医科大学学报,2014,49(11):1610-1613.DOI:10.19405/j.cnki.issn1000-1492.2014.11.020
[35]Yang X,Zhao C,Gao Z,et al.A novel regulator of lung inflammation and immunity:pulmonary parasympathetic inflammatory reflex[J].QJM,2014,107(10):789-792.DOI:10.1093/qjmed/hcu005.
[36]Xie Y,Tao S,Pan B,et al.Cholinergic anti-inflammatory pathway mediates diesel exhaust PM2.5-induced pulmonary and systemic inflammation[J].J Hazard Mater,2023(458):131951.DOI:10.1016/j.jhazmat.2023.131951.
[37]李俞羲,初奇,曹惠鹃,等.α7烟碱型胆碱能受体激动剂对体外循环致大鼠肺损伤影响及其机制研究[J].临床军医杂志,2020,48(6):672-675.DOI:10.16680/j.1671-3826.2020.06.16.
[38]Yang Z, Yin Q, Olatunji OJ, et al. Activation of cholinergic anti-inflammatory pathway involved in therapeutic actions of α-mangostin on lipopolysaccharide-induced acute lung injury in rats[J].Int J Immunopathol Pharmacol,2020(34):2058738420954941.DOI:10.1177/2058738420954941.
[39]Bencherif M,Lippiello PM,Lucas R,et al.Alpha7 nicotinic receptors as novel therapeutic targets for inflammation-based diseases[J].Cell Mol Life Sci,2011,68(6):931-949.DOI:10.1007/s00018-010-0525-1.
[40]杜朝晖,李建国,王焱林.胆碱能抗炎通路对感染性休克大鼠肺的保护作用[J].武汉大学学报(医学版),2007,28(6):703-706,750.DOI:10.3969/j.issn.1671-8852.2007.06.004.
[41]Sitapara RA,Gauthier AG,Valdés-Ferrer SI,et al.The α7 nicotinic acetylcholine receptor agonist,GTS-21,attenuates hyperoxia-induced acute inflammatory lung injury by alleviating the accumulation of HMGB1 in the airways and the circulation[J].Mol Med,2020,26(1):63.DOI:10.1186/s10020-020-00177-z.
[42]吉维忠,张亚清,格日力.慢性低压低氧暴露对大鼠学习记忆能力及神经元凋亡水平的影响[J].中华老年心脑血管病杂志,2021,23(3):301-305.DOI:10.3969/j.issn.1009-0126.2021.03.020.