糖酵解代谢重编程视角下鼻部炎症性疾病的发病机制及治疗策略
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1)河南中医药大学第二临床医学院,郑州 450046;2)河南中医药大学第二附属医院/河南省中医院,郑州 450002

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河南省中医药科学研究专项(2023ZYZD08)和中医药古籍文献和特色技术传承项目(0686-204001171345N)资助。


The Pathogenesis and Therapeutic Strategies of Nasal Inflammatory Diseases From The Perspective of Glycolytic Metabolic Reprogramming
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1)The Second Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou 450046, China;2)The Second Affiliated Hospital of Henan University of Traditional Chinese Medicine/Henan Provincial Hospital of Traditional Chinese Medicine, Zhengzhou 450002, China

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This work was supported by grants from Henan Provincial Traditional Chinese Medicine Science Research Special Project (2023ZYZD08) and Traditional Chinese Medicine Ancient Books Literature and Characteristic Technology Inheritance Project (0686-204001171345N).

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    摘要:

    糖酵解异常激活是驱动鼻部炎症发生发展的关键代谢机制。变应性鼻炎、慢性鼻窦炎和血管运动性鼻炎虽病因各异,但均涉及炎症反应、上皮屏障功能障碍和神经血管调节异常,而糖酵解代谢重编程贯穿其中,成为连接免疫代谢与炎症调控的核心枢纽。近年来研究表明,糖酵解依赖性免疫细胞活化为炎症启动提供能量基础。树突状细胞、嗜酸性粒细胞、肥大细胞及2型辅助T细胞(T helper 2 cell,Th2 cell)中,己糖激酶2(hexokinase 2,HK2)、丙酮酸激酶M2(pyruvate kinase M2,PKM2)、乳酸脱氢酶A(lactate dehydrogenase A,LDHA)表达上调,通过哺乳动物雷帕霉素靶蛋白(mammalian target of rapamycin,mTOR)-低氧诱导因子1α(hypoxia-inducible factor 1-alpha,HIF-1α)轴驱动细胞活化和促炎因子释放,乳酸作为核心代谢产物,通过酸化微环境激活瞬时受体电位香草酸亚型1(transient receptor potential vanilloid 1,TRPV1)通道促进神经肽释放,及通过G蛋白偶联受体81(G protein-coupled receptor 81,GPR81)介导免疫细胞趋化,形成代谢-炎症恶性循环,上皮细胞的糖酵解重编程受表皮生长因子(epidermal growth factor,EGF)/表皮生长因子受体(epidermal growth factor receptor,EGFR)信号调控,其失衡可导致紧密连接破坏、杯状细胞异常增生及组织重塑,感觉神经元释放的P物质和降钙素基因相关肽,通过激活肥大细胞与代谢产物协同形成持续炎症刺激。在治疗前景方面,糖酵解抑制剂(2-脱氧葡萄糖、FX11、3-溴丙酮酸)通过靶向HK2、LDHA等关键酶发挥抗炎作用,中药复方、单体活性成分及化学小分子通过调控mTOR-HIF-1α轴、抗氧化及内质网应激等通路,展现出调控鼻部炎症的潜在价值。本综述系统阐释糖酵解作为不同鼻炎亚型的共同代谢节点,为开发基于代谢重编程的精准治疗策略提供了新的理论方向。

    Abstract:

    Aberrant activation of glycolysis represents a key metabolic mechanism underlying the initiation and progression of nasal inflammation. Allergic rhinitis, chronic rhinosinusitis, and vasomotor rhinitis exhibit distinct etiologies, yet all are characterized by inflammatory responses, impaired epithelial barrier function, and neurovascular dysregulation, in which glycolytic metabolic reprogramming acts as a central hub connecting immunometabolism and inflammatory regulation.Recent evidence indicates that glycolysis-dependent activation of immune cells provides the essential energy basis for inflammatory onset. In dendritic cells, eosinophils, mast cells, and Th2 cells, the expression of key glycolytic enzymes including HK2, PKM2, and LDHA is upregulated, thereby promoting cellular activation and proinflammatory cytokine release via the mTOR-HIF-1α signaling axis. Notably, the metabolic reprogramming of eosinophils prolongs their survival and enhances the release of cytotoxic granules, while in mast cells, enhanced glycolysis facilitates IgE-mediated degranulation and histamine release. Furthermore, glycolysis also influences the Th17/Treg balance, with enhanced glycolytic flux promoting Th17 differentiation and contributing to the heterogeneous inflammatory profiles observed across different rhinitis subtypes.As a central metabolite, lactate contributes to the formation of a metabolism-inflammation vicious cycle through multiple mechanisms. Lactate acidifies the local microenvironment to activate TRPV1 channels and facilitate neuropeptide release, mediates immune cell chemotaxis through GPR81, and regulates gene expression via histone lactylation, thereby sustaining proinflammatory gene transcription. These lactate-mediated processes collectively amplify local inflammation and contribute to the persistence of nasal symptoms.Glycolytic reprogramming in epithelial cells is modulated by the EGF/EGFR pathway, and its dysregulation may result in disrupted tight junctions, abnormal goblet cell hyperplasia, and subsequent tissue remodeling. Substance P and calcitonin gene-related peptide released from sensory neurons, in conjunction with metabolic products, synergistically maintain persistent inflammatory stimulation by activating mast cells, forming a neuro-immune-metabolic regulatory network that drives disease chronicity.From a therapeutic perspective, glycolytic inhibitors such as 2-deoxyglucose, FX11, and 3-bromopyruvate exert anti-inflammatory effects by targeting key enzymes including HK2 and LDHA, each with distinct mechanisms: 2-DG competitively inhibits hexokinase, FX11 selectively targets LDHA to reduce lactate production, and 3-BrPA modulates multiple glycolytic enzymes. Moreover, traditional Chinese medicine formulas, monomeric active components, and small-molecule compounds have shown promising potential in alleviating nasal inflammation by regulating the mTOR-HIF-1α axis, exerting antioxidant effects, and modulating endoplasmic reticulum stress pathways. The multi-target characteristics of these natural products offer advantages in addressing the complex pathophysiology of nasal inflammatory diseases.Despite these advances, several challenges remain. The non-selective inhibition of glycolysis may interfere with epithelial repair and mucosal regeneration, leading to delayed wound healing. Technical limitations in dynamic metabolic monitoring and sampling precision hinder the accurate assessment of local nasal metabolism. Furthermore, current animal models, which predominantly rely on acute stimulation protocols, inadequately recapitulate the chronic tissue remodeling processes characteristic of human rhinitis.This review systematically summarizes glycolysis as a common metabolic node shared by different rhinitis subtypes, offering a novel theoretical basis for the development of precision therapeutic strategies targeting metabolic reprogramming.

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李梦为,蔡纪堂,王俊杰,蔡一博,谭梦婷.糖酵解代谢重编程视角下鼻部炎症性疾病的发病机制及治疗策略[J].生物化学与生物物理进展,2026,53(5):1333-1355 LI Meng-Wei, CAI Ji-Tang, WANG Jun-Jie, CAI Yi-Bo, TAN Meng-Ting. The Pathogenesis and Therapeutic Strategies of Nasal Inflammatory Diseases From The Perspective of Glycolytic Metabolic Reprogramming[J]. Progress in Biochemistry and Biophysics,2026,53(5):1333-1355

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  • 收稿日期:2026-01-20
  • 最后修改日期:2026-04-22
  • 录用日期:2026-04-06
  • 在线发布日期: 2026-04-07
  • 出版日期: 2026-05-28
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