动脉粥样硬化(atherosclerosis)是多种心血管疾病的共同病理基础,其基本特征是脂质沉积和炎症浸润。巨噬细胞作为重要的免疫细胞,参与了动脉粥样硬化的整个过程。近期研究表明,巨噬细胞胞葬作用(macrophage efferocytosis)是一种维持体内平衡的机制,可通过清除死亡/凋亡细胞消除炎症反应。在动脉粥样硬化中,巨噬细胞胞葬作用受损使凋亡细胞和坏死组织在斑块内异常堆积,从而导致坏死核心扩大、管腔狭窄加剧、斑块内炎症加重,最终造成斑块不稳定或破裂。本文概括了心血管生理过程中的胞葬作用,重点综述了巨噬细胞胞葬作用异常对动脉粥样硬化的影响及机制,以期为该类疾病提供潜在治疗靶点。

Atherosclerosis, characterized by excess lipid deposition and chronic inflammation, is the common pathological basis of cardiovascular diseases. Macrophages, as important immune cells, are involved in the entire process of atherosclerosis. Recent studies have shown that macrophage efferocytosis is a homeostatic mechanism responsible for the clearance of dead/apoptotic cells and the resolution of inflammation. In atherosclerosis, the capacity of macrophages to participate in efferocytosis is hampered, resulting in the abnormal accumulation of apoptotic cells and necrotic tissue within the plaques, which leads to the enlargement of necrotic core, increased luminal stenosis, plaque inflammation, and ultimate plaque destabilization or rupture. In this review, we summarized the efferocytic machinery that is normally implicated in cardiovascular physiology and then highlighted the mechanisms by which efferocytosis fails in atherosclerosis, aiming to provide therapeutic approaches for this pathological process.