论文摘要
研究背景: 人类第一杀手——冠心病是由于冠脉血管病变导致心肌细胞缺血、缺氧,使该支冠脉血管(包括微循环)及所支配区域的心肌细胞凋亡、坏死,血运重建是其治疗的关键所在。人们正在致力于寻求血运重建方法。近年来,随着分子生物学技术的发展,采用基因治疗促血管新生以改善缺血心肌的血供(也称分子搭桥术),成为目前冠脉血运重建术中比较具有发展前景的方向。机体在许多生理和病理状态下均可发生血管新生(angiogenesis),它是指从原有毛细血管基础上长出新血管的生物学过程。在血管新生的过程中参与的基因主要有:血管内皮生长因子(vascular endothelial growth factor,VEGF)及其受体、成纤维细胞生长因子(fibroblast growth factor,FGF)等,它们参与了血管内皮细胞的分化、增殖、血管形成及成熟。这些基因已经初步应用于临床治疗,虽然Ⅰ期临床试验的结果证明安全有效,但Ⅱ期临床试验结果并不理想。资料显示VEGF治疗后可出现新生血管不成熟、组织水肿、血管渗漏等副作用,而FGF治疗则会发生蛋白尿等副作用。因此人们在寻求能促进多基因表达的因子,以诱导生理功能完整的血管新生。缺氧诱导因子1(hypoxia-inducible factor-1,HIF-1)进入了人们的研究视线。 HIF-1是缺氧病理生理发展过程中占有主要调节地位的转录因子,同时发现其对血管新生有很强的调节作用,其转录活性和蛋白表达水平受氧浓度调节。HIF-1由HIF-1α和HIF-1β两个亚单位组成,HIF-1α为其氧依赖的主要调节单位。HIF-1α包括两个主要结构,氧依赖降解区(oxygen dependent degradation domain,
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