巨噬细胞自噬和线粒体代谢重编程在心肌梗死治疗中的作用
The role of macrophage autophagy and mitochondrial metabolic reprogramming in the treatment of myocardial infarction.
摘要(中文译文)
心肌梗死（MI）是一种危及生命的心血管事件，尽管现有治疗手段不断进步，预防其后续心力衰竭仍是重大临床挑战。修复结局在很大程度上取决于心脏免疫微环境，其中巨噬细胞发挥关键作用。巨噬细胞从促炎表型向修复表型的功转换由线粒体代谢重编程驱动，而这一过程受自噬、尤其是有丝分裂自噬的调控。然而，巨噬细胞自噬-代谢轴在心肌梗死后修复中的整合作用尚未得到系统阐明。本综述全面审视巨噬细胞自噬与线粒体代谢重编程之间的相互作用，详细阐述有丝分裂自噬如何维持线粒体健康以抑制炎症，并为修复型巨噬细胞功能所必需的氧化代谢提供支持。讨论进一步延伸至高级调控机制，包括细胞器间通讯、机械感知以及细胞间线粒体转移。此外，本综述评估了新兴治疗策略，如精准纳米医学和多靶点干预，在糖尿病心肌梗死等复杂临床情境中的应用。同时，也探讨了关键挑战，包括巨噬细胞动力学的时空复杂性及转化瓶颈。通过整合现有认识，本综述建立了以巨噬细胞自噬-代谢轴为核心的新型免疫代谢框架，指出靶向该轴在优化心脏修复方面具有显著治疗潜力。本综述提供前瞻性视角，强调需要智能、时空精准的治疗平台，以推动心肌梗死靶向治疗的发展。
Abstract
Myocardial infarction (MI) is a life-threatening cardiovascular event, and preventing subsequent heart failure remains a major clinical challenge despite available treatments. The repair outcome critically depends on the cardiac immune microenvironment, where macrophages play a pivotal role. Their functional switch from pro-inflammatory to reparative phenotypes is driven by mitochondrial metabolic reprogramming, a process regulated by autophagy, particularly mitophagy. However, the integrated role of the macrophage autophagy-metabolism axis in post-MI repair is not fully systematized. This review comprehensively examines the interplay between macrophage autophagy and mitochondrial metabolic reprogramming. It details how mitophagy maintains mitochondrial fitness to suppress inflammation and fuel the oxidative metabolism essential for reparative macrophage function. The discussion extends to advanced regulatory mechanisms, including inter-organelle communication, mechanosensing, and intercellular mitochondrial transfer. Furthermore, the review evaluates emerging therapeutic strategies, such as precision nanomedicine and multi-target interventions, within complex clinical contexts like diabetic MI. Key challenges, including the spatiotemporal complexity of macrophage dynamics and translational bottlenecks, are also addressed. By synthesizing current insights, this review establishes a novel immunometabolic framework centered on the macrophage autophagy-metabolism axis. It highlights that targeting this axis holds significant therapeutic potential for optimizing cardiac repair. The review provides forward-looking perspectives, emphasizing the need for intelligent, spatiotemporally precise therapeutic platforms to advance the development of targeted therapies for MI.
如何引用
AMA
Gongchang Zhang, Fengjuan Hu, Yiping Deng, Daiping Li, Tingting Huang, Lixing Zhou, et al. The role of macrophage autophagy and mitochondrial metabolic reprogramming in the treatment of myocardial infarction.. Journal of translational medicine. 2026; doi:10.1186/s12967-026-08383-9.
APA
Gongchang Zhang, Fengjuan Hu, Yiping Deng, Daiping Li, Tingting Huang, Lixing Zhou, et al (2026). The role of macrophage autophagy and mitochondrial metabolic reprogramming in the treatment of myocardial infarction.. Journal of translational medicine. https://doi.org/10.1186/s12967-026-08383-9
GB/T 7714
Gongchang Zhang, Fengjuan Hu, Yiping Deng, Daiping Li, Tingting Huang, Lixing Zhou, et al. The role of macrophage autophagy and mitochondrial metabolic reprogramming in the treatment of myocardial infarction.[J]. Journal of translational medicine, 2026 doi:10.1186/s12967-026-08383-9.
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