单细胞与空间组学视角下主动脉夹层血管壁细胞异质性及细胞互作
Cellular Heterogeneity and Intercellular Communication in the Aortic Wall of Aortic Dissection: Insights from Single-Cell and Spatial Omics
摘要: 主动脉夹层(aortic dissection, AD)进展快，血管壁失稳会牵涉到结构细胞状态改变、细胞外基质破坏、免疫炎症反应及异常力学应力等多个环节；单细胞RNA测序和空间组学能把细胞组成、状态变化与组织定位联系起来，补充了传统组织学和批量转录组学在细胞分辨率方面的不足。本综述围绕AD血管壁细胞异质性与细胞互作，梳理血管平滑肌细胞和巨噬细胞等关键细胞的连续表型谱、主要驱动因素及潜在可逆性，归纳趋化、代谢、内皮屏障和细胞外基质重塑相关网络，并把候选生物标志物、实验性干预靶点以及主动脉组织单细胞与空间组学研究的方法学挑战纳入同一框架。现有研究显示，AD血管壁损伤并不是由某一个孤立细胞亚群造成，而是多类结构细胞和免疫细胞在特定空间微环境中持续互作后共同推动病变进展；后续研究还需要在标准化取材、单细胞与单核测序选择、空间组学验证和多组学整合方面继续完善，从而推动细胞图谱发现向机制解释和临床转化延伸。
Abstract: Aortic dissection (AD) is a rapidly progressive aortic disease in which vascular-wall destabilization involves structural-cell remodeling, extracellular matrix disruption, immune inflammation, and abnormal mechanical stress. Single-cell RNA sequencing and spatial omics link cellular composition, state changes, and tissue localization, thereby complementing conventional histology and bulk transcriptomics. This review focuses on cellular heterogeneity and intercellular communication in the dissected aortic wall, summarizes the continuous phenotypic spectra, major driving factors, and potential reversibility of key cell types such as vascular smooth muscle cells and macrophages, integrates interaction networks related to chemotaxis, metabolism, endothelial barrier function, and extracellular matrix remodeling, and incorporates candidate biomarkers, experimental therapeutic targets, and methodological challenges into a unified framework. Current studies suggest that aortic-wall injury in AD is not driven by a single isolated cell subset but by sustained interactions among structural and immune cells within specific spatial microenvironments. Future work should further improve standardized sampling, selection between single-cell and single-nucleus sequencing, spatial validation, and multi-omics integration, so as to advance cellular atlas findings toward mechanistic interpretation and clinical translation.
文章引用：曾照红, 刘峰. 单细胞与空间组学视角下主动脉夹层血管壁细胞异质性及细胞互作[J]. 临床医学进展, 2026, 16(7): 2137-2146. https://doi.org/10.12677/acm.2026.1672742

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