新生儿急性肺损伤的发病机制

doi:10.16352/j.issn.1001-6325.2025.01.0135

摘要/Abstract

摘要： 新生儿由于气道较窄、肺泡发育不完全等因素易发生新生儿急性肺损伤(ALI),严重者可发展为新生儿急性呼吸窘迫综合征(ARDS)。导致新生儿ALI发生及进展的机制涉及各个方面,主要包括氧化应激、铁死亡、炎性反应和肺表面活性物质的减少。期待相关机制的进一步研究可以为探索新型治疗方案提供方向。

关键词: 新生儿, 急性肺损伤, 急性呼吸窘迫综合征, 发病机制

Abstract: Due to factors such as narrow airways and incomplete development of alveoli, newborns are prone to acute lung injury (ALI), which may progress to severe condition known as acute respiratory distress syndrome (ARDS). The mechanisms underlying the occurrence and progression of ALI in newborns involve various aspects, including oxidative stress, iron death, inflammatory response and reduction of pulmonary surfactant. Further research into these mechanisms is expected to provide strategy to guide clinical management in novo pathway.

Key words: fetus/newborns infant, acute lung injury, acute respiratory distress syndrome, pathogenesis

中图分类号:

R722.1

杨若彤, 赵国英, 王浩. 新生儿急性肺损伤的发病机制[J]. 基础医学与临床, 2025, 45(1): 135-139.

YANG Ruotong, ZHAO Guoying, WANG Hao. Pathogenesis of acute lung injury of the newborns[J]. Basic & Clinical Medicine, 2025, 45(1): 135-139.

参考文献

[1] De Luca D, Tingay DG, van Kaam AH, et al Epidemio-logy of neonatal acute respiratory distress syndrome: prospective, multicenter, international cohort study[J]. Pediatr Crit Care Med, 2022, 23:524-534. doi:10.1097/PCC.0000000000002961.
[2] Lin M, Xie W, Xiong D, et al Cyasterone ameliorates sepsis-related acute lung injury via AKT (Ser473)/GSK3β (Ser9)/Nrf2 pathway[J]. Chin Med, 2023,18:136. doi:10.1186/s13020-023-00837-2.
[3] Xin Y, Zou L, Lang S. 4-Octyl itaconate (4-OI) attenuates lipopolysaccharide-induced acute lung injury by suppressing PI3K/Akt/NF-κB signaling pathways in mice[J]. Exp Ther Med, 2021,21:141. doi:10.3892/etm.2020.9573.
[4] Fang J, Huang Q, Shi C, et al Songorine inhibits oxidative stress-related inflammation through PI3K/AKT/NRF2 signaling pathway to alleviate lipopolysaccharide-induced septic acute lung injury[J]. Immunopharmacol Immunotoxicol, 2024, 46:152-160. doi:10.1080/08923973.2023.2281902.
[5] Zhu L, Wei M, Yang N, et al Glycyrrhizic acid alleviates the meconium-induced acute lung injury in neonatal rats by inhibiting oxidative stress through mediating the Keap1/Nrf2/HO-1 signal pathway[J]. Bioengineered, 2021,12:2616-2626.
[6] Kang JY, Xu MM, Sun Y, et al Melatonin attenuates LPS-induced pyroptosis in acute lung injury by inhibiting NLRP3-GSDMD pathway via activating Nrf2/HO-1 signal-ing axis[J]. Int Immunopharmacol, 2022,109:108782. doi:10.1016/j.intimp.2022.108782.
[7] Millar MW, Fazal F, Rahman A. Therapeutic targeting of NF-κB in acute lung injury: adouble-edged sword[J]. Cells, 2022,11:3317. Published 2022 Oct 21. doi:10.3390/cells11203317.
[8] Duan Q, Jia Y, Qin Y, et al Narciclasine attenuates LPS-induced acute lung injury in neonatal rats through suppressing inflammation and oxidative stress[J]. Bioengineered, 2020,11:801-810. doi:10.1080/21655979.2020.1795424.
[9] Chou HC, Chen CM. Hyperoxia induces ferroptosis and impairs lung development in neonatal mice[J]. Antioxidants (Basel), 2022,11:641. doi:10.3390/antiox11040641.
[10] Robbins ME, Cho HY, Hansen JM, et al Glutathione reductase deficiency alters lung development and hyperoxic responses in neonatal mice[J]. Redox Biol, 2021,38:101797. doi:10.1016/j.redox.2020.101797.
[11] Chou HC, Chen CM. Cathelicidin attenuates hyperoxia-induced lung injury by inhibiting ferroptosis in newborn rats[J]. Antioxidants (Basel), 2022,11:2405. doi:10.3390/antiox11122405.
[12] Wang X, Zhang C, Zou N, et al Lipocalin-2 silencing suppresses inflammation and oxidative stress of acute respiratory distress syndrome by ferroptosis via inhibition of MAPK/ERK pathway in neonatal mice[J]. Bioengineered, 2022,13:508-520. doi:10.1080/21655979.2021.2009970.
[13] Wang RX, Gu X, Zhang SX, et al Deletion of BACH1 alleviates ferroptosis and protects against LPS-triggered acute lung injury by activating Nrf2/HO-1 signaling pathway[J]. Biochem Biophys Res Commun, 2023, 644:8-14. doi:10.1016/j.bbrc.2023.01.002.
[14] Kuganesan N, Dlamini S, Tillekeratne LMV, et al Tumor suppressor p53 promotes ferroptosis in oxidative stress conditions independent of modulation of ferroptosis by p21, CDKs, RB, and E2F[J]. J Biol Chem, 2021, 297:101365. doi:10.1016/j.jbc.2021.101365.
[15] Cao Y, Peng T, Ai C, et al Inhibition of SIRT6 aggravates p53-mediated ferroptosis in acute lung injury in mice[J]. Heliyon, 2023,9:e22272. doi:10.1016/j.heliyon.2023.e22272.
[16] Yang Y, Ma Y, Li Q, et al STAT6 inhibits ferroptosis and alleviates acute lung injury via regulating p53/SLC7A11 pathway[J]. Cell Death Dis, 2022,13:530. doi:10.1038/s41419-022-04971-x.
[17] Al Gharaibeh FN, Kempton KM, Alder MN. Olfactomedin-4-positive neutrophils in neonates: link to systemic inflammation and bronchopulmonary dysplasia[J]. Neonatology, 2023,120:40-48. doi:10.1159/000527902.
[18] Pan WH, Hu X, Chen B, et al The effect and mechanism of Lipoxin A4 on neutrophil function in LPS-induced lung injury[J]. Inflammation, 2022;45:1950-1967.
[19] Min JH, Kim SM, Park JW, et al Lagerstroemia ovalifolia exerts anti-inflammatory effects in mice of LPS induced ALI via downregulating of MAPK and NF-κB activation[J]. J Microbiol Biotechnol, 2021,31:1501-1507. doi:10.4014/jmb.2107.07023.
[20] Puri G, Naura AS. Implication of mitochondrial ROS-NLRP3 inflammasome axis during two-hit mediated acute lung injury in mice[J]. Free Radic Res, 2022,56:1-16. doi:10.1080/10715762.2021.2023740.
[21] Yu X, Li C. Protective effects of propofol on experimental neonatal acute lung injury[J]. Mol Med Rep, 2019,19:4507-4513. doi:10.3892/mmr.2019.10113.
[22] Xie B, Li S, Bai W, et al Artesunate alleviates hyperoxia-induced lung injury in neonatal mice by inhibiting NLRP3 inflammasome activation[J]. Evid Based Complement Alternat Med, 2023,2023:7603943. doi:10.1155/2023/7603943.
[23] You H, Huang X. Effect of pulmonary surfactant on the prevention of neonatal respiratory distress syndrome in premature infants[J]. Am J Transl Res, 2021,13:3642-3649.
[24] Qing Q, Zha P, Dai LY, et al Effect of different ventilation methods combined with pulmonary surfactant on neonatal acute respiratory distress syndrome[J]. World J Clin Cases, 2023,11:5878-5886.
[25] Abdelwahab EMM, Rapp J, Feller D, et al Wnt signaling regulates trans-differentiation of stem cell like type 2 alveolar epithelial cells to type 1 epithelial cells[J]. Respir Res, 2019, 20:204. doi:10.1186/s12931-019-1176-x.