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已发表论文
葡萄糖代谢重编程中间产物调节巨噬细胞极化：改善肺血管重塑的重要方向
Authors Wang J, Yuan R, Zhang S, Xu Z, Song L
Received 21 May 2025
Accepted for publication 3 November 2025
Published 17 November 2025 Volume 2025:18 Pages 16045—16062
DOI https://doi.org/10.2147/JIR.S541649
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Rongxue Wu
Junqi Wang,1,2 Rong Yuan,1,2 Shengkang Zhang,3 Zhaojun Xu,2,3 Lan Song1,2
1Medicine School, Hunan University of Chinese Medicine, Changsha, Hunan, 410208, People’s Republic of China; 2Hunan Provincial Key Laboratory of Vascular Biology and Translational Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, 410208, People’s Republic of China; 3Cardiothoracic Surgery of the First Affiliated Hospital, Hunan University of Chinese Medicine, Changsha, Hunan, 410007, People’s Republic of China
Correspondence: Zhaojun Xu, Cardiothoracic Surgery of the First Affiliated Hospital, Hunan University of Chinese Medicine, Changsha, Hunan, 410007, People’s Republic of China, Email xuzj1492@163.com Lan Song, Medicine School, Hunan University of Chinese Medicine, Changsha, Hunan, 410208, People’s Republic of China, Email songlan311492@hnucm.edu.cn
Abstract: Pulmonary vascular remodeling (PVR) is a key pathological basis for various lung diseases and is centered on macrophage-driven pathological vascular remodeling. Macrophage functional polarization is closely related to metabolic reprogramming, a process that not only encompasses energy supply but also dictates cellular function through metabolic intermediates. To bridge the knowledge gap between metabolic regulation and clinical translation in PVR, this review focuses on key metabolites produced during glucose metabolism: pyruvate, citrate, succinate, and itaconate. These intermediates are not merely metabolic byproducts; rather, they directly influence the pathological processes of vascular endothelial cells, smooth muscle cells, and the extracellular matrix by modulating the polarization of macrophages. This review systematically elucidates the precise regulatory mechanisms of these metabolic signals, with the aim of providing new diagnostic and therapeutic targets for PVR. It emphasizes the immense potential of targeting metabolic intermediates for future precision medicine, ultimately promoting a paradigm shift in PVR therapy from traditional anti-proliferative interventions to an innovative model based on metabolic reprogramming.
Keywords: pulmonary vascular remodeling, macrophage polarization, glycolytic reprogramming, pyruvate, citrate, succinate, itaconate
1Medicine School, Hunan University of Chinese Medicine, Changsha, Hunan, 410208, People’s Republic of China; 2Hunan Provincial Key Laboratory of Vascular Biology and Translational Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, 410208, People’s Republic of China; 3Cardiothoracic Surgery of the First Affiliated Hospital, Hunan University of Chinese Medicine, Changsha, Hunan, 410007, People’s Republic of China
Correspondence: Zhaojun Xu, Cardiothoracic Surgery of the First Affiliated Hospital, Hunan University of Chinese Medicine, Changsha, Hunan, 410007, People’s Republic of China, Email xuzj1492@163.com Lan Song, Medicine School, Hunan University of Chinese Medicine, Changsha, Hunan, 410208, People’s Republic of China, Email songlan311492@hnucm.edu.cn
Abstract: Pulmonary vascular remodeling (PVR) is a key pathological basis for various lung diseases and is centered on macrophage-driven pathological vascular remodeling. Macrophage functional polarization is closely related to metabolic reprogramming, a process that not only encompasses energy supply but also dictates cellular function through metabolic intermediates. To bridge the knowledge gap between metabolic regulation and clinical translation in PVR, this review focuses on key metabolites produced during glucose metabolism: pyruvate, citrate, succinate, and itaconate. These intermediates are not merely metabolic byproducts; rather, they directly influence the pathological processes of vascular endothelial cells, smooth muscle cells, and the extracellular matrix by modulating the polarization of macrophages. This review systematically elucidates the precise regulatory mechanisms of these metabolic signals, with the aim of providing new diagnostic and therapeutic targets for PVR. It emphasizes the immense potential of targeting metabolic intermediates for future precision medicine, ultimately promoting a paradigm shift in PVR therapy from traditional anti-proliferative interventions to an innovative model based on metabolic reprogramming.
Keywords: pulmonary vascular remodeling, macrophage polarization, glycolytic reprogramming, pyruvate, citrate, succinate, itaconate