{"id":26623,"date":"2023-04-28T19:45:45","date_gmt":"2023-04-28T12:45:45","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=26623"},"modified":"2023-04-28T19:45:45","modified_gmt":"2023-04-28T12:45:45","slug":"neutrophils-vai-tro-that-su-trong-phan-ung-viem-cap","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/28\/neutrophils-vai-tro-that-su-trong-phan-ung-viem-cap\/","title":{"rendered":"Neutrophils: Vai tr\u00f2 th\u1eadt s\u1ef1 trong ph\u1ea3n \u1ee9ng vi\u00eam c\u1ea5p"},"content":{"rendered":"<p>Neutrophils l\u00e0 lo\u1ea1i t\u1ebf b\u00e0o b\u1ea1ch c\u1ea7u l\u01b0u h\u00e0nh ph\u1ed5 bi\u1ebfn nh\u1ea5t trong c\u01a1 th\u1ec3. Nh\u1eefng t\u1ebf b\u00e0o n\u00e0y \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch b\u1ea9m sinh v\u00e0 tham gia v\u00e0o giai \u0111o\u1ea1n \u0111\u1ea7u c\u1ee7a vi\u00eam v\u00e0 nhi\u1ec5m tr\u00f9ng. Vai tr\u00f2 c\u1ee7a Neutrophils c\u00e0ng \u0111\u01b0\u1ee3c th\u1ec3 hi\u1ec7n r\u00f5 n\u00e9t trong \u0111\u00e1p \u1ee9ng vi\u00eam c\u1ea5p.<\/p>\n<h2>1. Gi\u1edbi thi\u1ec7u<\/h2>\n<p>Neutrophils (b\u1ea1ch c\u1ea7u trung t\u00ednh) l\u00e0 m\u1ed9t trong nh\u1eefng t\u1ebf b\u00e0o ch\u00ednh c\u1ee7a h\u1ec7 mi\u1ec5n d\u1ecbch b\u1ea9m sinh, \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong vi\u1ec7c ch\u1ed1ng l\u1ea1i v\u1edbi c\u00e1c t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh. Trong b\u00e0i vi\u1ebft n\u00e0y, ch\u00fang ta s\u1ebd \u0111i s\u00e2u v\u00e0o c\u00e1c ho\u1ea1t \u0111\u1ed9ng ch\u00ednh c\u1ee7a neutrophils, bao g\u1ed3m: Tho\u00e1t m\u1ea1ch, qu\u00e1 tr\u00ecnh th\u1ef1c b\u00e0o &#8211; phagocytosis, ti\u00eau di\u1ec7t t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh: oxidative killing v\u00e0 non-oxidative killing, c\u0169ng nh\u01b0 vai tr\u00f2 c\u1ee7a ch\u00fang trong ch\u1ebft t\u1ebf b\u00e0o theo ch\u01b0\u01a1ng tr\u00ecnh (apoptosis) v\u00e0 h\u00ecnh th\u00e0nh m\u1ee7 (pus).<\/p>\n<h2>2. Vai tr\u00f2 c\u1ee7a Neutrophils<\/h2>\n<h3>2.1 S\u1ef1 tho\u00e1t m\u1ea1ch c\u1ee7a neutrophils<\/h3>\n<p>Tho\u00e1t m\u1ea1ch l\u00e0 s\u1ef1 di chuy\u1ec3n c\u1ee7a neutrophils t\u1eeb trong l\u00f2ng m\u1ea1ch \u0111\u1ebfn c\u00e1c v\u1ecb tr\u00ed vi\u00eam, c\u00e1c m\u00f4 t\u1ed5n th\u01b0\u01a1ng. Qu\u00e1 tr\u00ecnh n\u00e0y di\u1ec5n ra qua 5 b\u01b0\u1edbc:<\/p>\n<ul>\n<li><strong>T\u1ee5 v\u00e1ch (margination):<\/strong> S\u1ef1 gi\u00e3n m\u1ea1ch c\u1ee7a qu\u00e1 tr\u00ecnh vi\u00eam l\u00e0m ch\u1eadm s\u1ef1 l\u01b0u th\u00f4ng c\u1ee7a m\u00e1u, l\u00e0m cho b\u1ea1ch c\u1ea7u trung t\u00ednh \u0111\u01b0\u1ee3c \u0111\u01b0a \u0111\u1ebfn v\u00e1ch c\u1ee7a m\u1ea1ch m\u00e1u.<\/li>\n<li><strong>Qu\u00e1 tr\u00ecnh &#8220;l\u0103n&#8221; (rolling):<\/strong> Neutrophils sau khi ho\u00e0n th\u00e0nh b\u01b0\u1edbc t\u1ee5 v\u00e1ch s\u1ebd \u0111\u01b0\u1ee3c li\u00ean k\u1ebft y\u1ebfu v\u1edbi th\u00e0nh m\u1ea1ch th\u00f4ng qua P-selectins v\u00e0 E-selectins g\u1eafn v\u1edbi c\u1ea5u tr\u00fac Sialyl Lewis X. Trong \u0111\u00f3, histamin \u0111\u01b0\u1ee3c ph\u00f3ng th\u00edch t\u1eeb qu\u00e1 tr\u00ecnh vi\u00eam s\u1ebd k\u00edch th\u00edch t\u1ebf b\u00e0o n\u1ed9i m\u00f4 m\u1ea1ch m\u00e1u h\u00ecnh th\u00e0nh th\u1ec3 Weibel-Palade. Th\u1ec3 n\u00e0y t\u1ea1o ra P-selectins g\u1eafn v\u1edbi c\u1ea5u tr\u00fac Sialyl Lewis X tr\u00ean t\u1ebf b\u00e0o neutrophils. E-selectins \u0111\u01b0\u1ee3c h\u00ecnh th\u00e0nh nh\u1edd v\u00e0o t\u00e1c d\u1ee5ng c\u1ee7a c\u00e1c y\u1ebfu t\u1ed1 INF v\u00e0 IL-1 trong qu\u00e1 tr\u00ecnh vi\u00eam.<\/li>\n<li>\u00a0<strong>Li\u00ean k\u1ebft ch\u1eb7t (adhesion):<\/strong> Th\u1ee5 th\u1ec3 CD18 tr\u00ean Neutrophils, \u0111\u01b0\u1ee3c h\u00ecnh th\u00e0nh nh\u1edd s\u1ef1 k\u00edch th\u00edch c\u1ee7a C5a v\u00e0 LTB4, s\u1ebd g\u1eafn v\u1edbi c\u00e1c t\u1ebf b\u00e0o n\u1ed9i m\u00f4 m\u1ea1ch m\u00e1u nh\u1edd v\u1edbi c\u00e1c ph\u00e2n t\u1eed li\u00ean k\u1ebft t\u1ebf b\u00e0o CAMs (adhesion molecules). Ph\u00e2n t\u1eed CAMs bao g\u1ed3m ICAM (intercellular CAM) v\u00e0 VCAM (vascular CAM), ch\u00fang \u0111\u01b0\u1ee3c h\u00ecnh th\u00e0nh nh\u1edd s\u1ef1 k\u00edch th\u00edch c\u1ee7a c\u00e1c y\u1ebfu t\u1ed1 TNF v\u00e0 Il-1.<\/li>\n<li><strong>Xuy\u00ean m\u1ea1ch (transmigration):<\/strong> \u1ede Neutrophils v\u00e0 t\u1ebf b\u00e0o n\u1ed9i m\u00f4 m\u1ea1ch m\u00e1u \u0111\u1ec1u c\u00f3 ph\u00e2n t\u1eed PECAM-1 (Platelet-endothelial cell adhesion molecule). Li\u00ean k\u1ebft gi\u1eefa hai ph\u00e2n t\u1eed PECAM-1 (PECAM-to-PECAM attachment) gi\u00fap cho Neutrophils xuy\u00ean qua th\u00e0nh m\u1ea1ch v\u00e0o m\u00f4 b\u1ecb t\u1ed5n th\u01b0\u01a1ng.<\/li>\n<li><strong>Ho\u00e1 h\u01b0\u1edbng \u0111\u1ed9ng (migration or chemotaxis)<\/strong>: B\u1ea1ch c\u1ea7u trung t\u00ednh \u0111\u01b0\u1ee3c \u0111i\u1ec1u \u0111\u1ed9ng \u0111\u1ebfn n\u01a1i c\u1ea7n th\u1ef1c b\u00e0o nh\u1edd c\u00e1c IL-8, C5a, LTB4 v\u00e0 c\u00e1c s\u1ea3n ph\u1ea9m vi khu\u1ea9n (chemotaxis).<\/li>\n<\/ul>\n<figure style=\"width: 1447px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/jlb.onlinelibrary.wiley.com\/cms\/asset\/74cf374d-b263-4262-b364-56ee518c725a\/jlb0617-fig-0002-m.jpg\" alt=\"Deep insight into neutrophil trafficking in various organs - Hyun - 2017 - Journal of Leukocyte Biology - Wiley Online Library\" width=\"1447\" height=\"1102\" \/><figcaption class=\"wp-caption-text\">Minh ho\u1ea1 v\u1ec1 vai tr\u00f2 tho\u00e1t m\u1ea1ch c\u1ee7a Neutrophils<\/figcaption><\/figure>\n<h3>2.2 Qu\u00e1 tr\u00ecnh th\u1ef1c b\u00e0o c\u1ee7a Neutrophils<\/h3>\n<p>Khi \u0111\u1ebfn n\u01a1i nhi\u1ec5m tr\u00f9ng ho\u1eb7c m\u00f4 t\u1ed5n th\u01b0\u01a1ng, Neutrophils s\u1ebd ti\u1ebfn h\u00e0nh th\u1ef1c b\u00e0o ch\u00fang. Qu\u00e1 tr\u00ecnh n\u00e0y b\u1eaft \u0111\u1ea7u khi c\u00e1c neutrophil &#8220;nu\u1ed1t&#8221; vi sinh v\u1eadt, m\u00f4 t\u1ed5n th\u01b0\u01a1ng v\u00e0 h\u00ecnh th\u00e0nh phagosome. Nh\u1eefng phagosome n\u00e0y sau \u0111\u00f3 s\u1ebd k\u1ebft h\u1ee3p v\u1edbi lysosome \u0111\u1ec3 t\u1ea1o ra phagolysosome, \u0111\u00e2y n\u01a1i m\u00e0 vi khu\u1ea9n b\u1ecb ti\u00eau di\u1ec7t v\u00e0 ph\u00e1 h\u1ee7y b\u1edfi enzyme v\u00e0 c\u00e1c ch\u1ea5t kh\u00e1ng khu\u1ea9n.<\/p>\n<h3>2.3 Qu\u00e1 tr\u00ecnh Neutrophils ti\u00eau di\u1ec7t t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh:<\/h3>\n<ul>\n<li><strong>Oxidative Killing:<\/strong> S\u1ef1 &#8220;b\u00f9ng n\u1ed5 h\u00f4 h\u1ea5p&#8221; (respiratory burst) c\u1ee7a Neutrophils t\u1ea1o ra c\u00e1c lo\u1ea1i g\u1ed1c oxy h\u00f3a ho\u1ea1t \u0111\u1ed9ng c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb oxy (Reactive oxygen species-ROS) \u0111\u1ec3 ti\u00eau di\u1ec7t t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh. Trong qu\u00e1 tr\u00ecnh n\u00e0y, NADPH oxidase chuy\u1ec3n \u0111\u1ed5i kh\u00ed oxy (O2) th\u00e0nh superoxide (O2-), sau \u0111\u00f3 \u0111\u01b0\u1ee3c chuy\u1ec3n \u0111\u1ed5i th\u00e0nh hydrogen peroxide (H2O2) b\u1edfi superoxide dismutase. H2O2 \u0111\u01b0\u1ee3c chuy\u1ec3n \u0111\u1ed5i th\u00e0nh hypochlorite (HOCl\u02d9) b\u1edfi myeloperoxidase (MPO), \u0111\u00e2y l\u00e0 ch\u1ea5t ph\u00e1 hu\u1ef7 c\u00e1c t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh.<\/li>\n<\/ul>\n<ul>\n<li><strong>Non-Oxidative Killing: <\/strong>M\u1eb7c d\u00f9 qu\u00e1 tr\u00ecnh oxidative killing r\u1ea5t hi\u1ec7u qu\u1ea3, nh\u01b0ng n\u00f3 kh\u00f4ng ph\u1ea3i l\u00e0 ph\u01b0\u01a1ng ti\u1ec7n duy nh\u1ea5t m\u00e0 Neutrophils c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng \u0111\u1ec3 ti\u00eau di\u1ec7t vi khu\u1ea9n. Neutrophil ph\u00f3ng th\u00edch lactoferrin, c\u00f3 kh\u1ea3 n\u0103ng k\u1ebft d\u00ednh v\u1edbi s\u1eaft t\u1ef1 do, khi\u1ebfn vi sinh v\u1eadt ch\u1ebft \u0111i do kh\u00f4ng s\u1eed d\u1ee5ng \u0111\u01b0\u1ee3c s\u1eaft. C\u00e1c t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch kh\u00e1c nh\u01b0 eosinophils, ph\u00f3ng th\u00edch h\u1ea1t ch\u1ee9a major basic protein (MBP) \u0111\u1ec3 ti\u00eau di\u1ec7t vi khu\u1ea9n v\u00e0 giun s\u00e1n. \u0110\u1ea1i th\u1ef1c b\u00e0o (macrophages) c\u0169ng ti\u1ebft ra lysozyme c\u00f3 t\u00e1c d\u1ee5ng ly gi\u1ea3i c\u00e1c peptidoglycan gi\u00fap ti\u00eau di\u1ec7t vi khu\u1ea9n.<\/li>\n<\/ul>\n<h2>3. Enzyme Catalase<\/h2>\n<p>B\u1ec7nh u h\u1ea1t m\u1ea1n t\u00ednh (Chronic Granulomatous Disease &#8211; CGD) l\u00e0 m\u1ed9t b\u1ec7nh di truy\u1ec1n khi\u1ebfn Neutrophils m\u1ea5t kh\u1ea3 n\u0103ng t\u1ea1o ra ROS do thi\u1ebfu NADPH oxidase. \u1ede nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y, Neutrophils v\u1eabn c\u00f3 th\u1ec3 ti\u00eau di\u1ec7t vi khu\u1ea9n b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng H2O2 \u0111\u01b0\u1ee3c s\u1ea3n xu\u1ea5t b\u1edfi ch\u00ednh vi khu\u1ea9n. Tuy nhi\u00ean, c\u00e1c lo\u1ea1i vi khu\u1ea9n c\u00f3 kh\u1ea3 n\u0103ng ti\u1ebft enzyme catalase c\u00f3 th\u1ec3 ph\u00e2n h\u1ee7y H2O2, khi\u1ebfn Neutrophils kh\u00f4ng th\u1ec3 t\u1ea1o ra HOCL- \u0111\u1ec3 ti\u00eau di\u1ec7t ch\u00fang.<\/p>\n<h2>4. Apoptosis v\u00e0 s\u1ef1 h\u00ecnh th\u00e0nh m\u1ee7<\/h2>\n<p>Qu\u00e1 tr\u00ecnh t\u1ea1o ra s\u1ef1 &#8220;b\u00f9ng n\u1ed5 h\u00f4 h\u1ea5p&#8221; (respiratory burst) l\u00e0 m\u1ed9t qu\u00e1 tr\u00ecnh \u0111\u00f2i h\u1ecfi nhi\u1ec1u n\u0103ng l\u01b0\u1ee3ng v\u00e0 d\u1eabn \u0111\u1ebfn s\u1ef1 c\u1ea1n ki\u1ec7t ngu\u1ed3n n\u0103ng l\u01b0\u1ee3ng c\u1ee7a t\u1ebf b\u00e0o, d\u1eabn \u0111\u1ebfn ch\u1ebft t\u1ebf b\u00e0o theo ch\u01b0\u01a1ng tr\u00ecnh (apoptosis). Vi khu\u1ea9n ch\u1ebft v\u00e0 b\u1ea1ch c\u1ea7u t\u00edch t\u1ee5 v\u00e0 t\u1ea1o th\u00e0nh ch\u1ea5t m\u1ee7, \u0111\u00f3 l\u00e0 m\u1ed9t d\u1ea5u hi\u1ec7u c\u1ee7a ph\u1ea3n \u1ee9ng vi\u00eam \u0111ang ho\u1ea1t \u0111\u1ed9ng.<br \/>\nTrong c\u00e1c tr\u1ea1ng th\u00e1i vi\u00eam m\u00e3n t\u00ednh, ch\u1eb3ng h\u1ea1n nh\u01b0 vi\u00eam kh\u1edbp th\u1ea5p v\u00e0 b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh, qu\u00e1 tr\u00ecnh ch\u1ebft t\u1ebf b\u00e0o theo ch\u01b0\u01a1ng tr\u00ecnh c\u1ee7a b\u1ea1ch c\u1ea7u b\u1ecb ch\u1eadm tr\u1ec5, d\u1eabn \u0111\u1ebfn vi\u00eam d\u1eef d\u1ed9i v\u00e0 t\u1ed5n th\u01b0\u01a1ng m\u00f4. Vi\u1ec7c hi\u1ec3u r\u00f5 c\u00e1c c\u01a1 ch\u1ebf li\u00ean quan \u0111\u1ebfn ch\u1ebft t\u1ebf b\u00e0o theo ch\u01b0\u01a1ng tr\u00ecnh v\u00e0 h\u00ecnh th\u00e0nh m\u1ee7 (pus) l\u00e0 r\u1ea5t quan tr\u1ecdng trong vi\u1ec7c ph\u00e1t tri\u1ec3n c\u00e1c chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb m\u1edbi cho c\u00e1c b\u1ec7nh vi\u00eam m\u1ea1n t\u00ednh.<\/p>\n<h2>5. K\u1ebft lu\u1eadn<\/h2>\n<p>Neutrophils \u0111\u00f3ng m\u1ed9t vai tr\u00f2 quan tr\u1ecdng trong h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch gi\u00fap ch\u1ed1ng l\u1ea1i v\u1edbi c\u00e1c t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh. C\u00e1c vai tr\u00f2 c\u1ee7a Neutrophils nh\u01b0 tho\u00e1t m\u1ea1ch, th\u1ef1c b\u00e0o &#8211; phagocytosis, ti\u00eau di\u1ec7t t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh: oxidative killing v\u00e0 non-oxidative killing, ch\u1ebft t\u1ebf b\u00e0o theo ch\u01b0\u01a1ng tr\u00ecnh (apoptosis) v\u00e0 h\u00ecnh th\u00e0nh m\u1ee7 (pus) l\u00e0 c\u1ef1c k\u1ef3 quan tr\u1ecdng \u0111\u1ed1i trong vi\u1ec7c ch\u1ed1ng l\u1ea1i c\u00e1c vi sinh v\u1eadt x\u00e2m nh\u1eadp. Hi\u1ec3u v\u1ec1 ch\u1ee9c n\u0103ng c\u1ee7a Neutrophils l\u00e0 r\u1ea5t c\u1ea7n thi\u1ebft \u0111\u1ed1i v\u1edbi c\u00e1c chuy\u00ean gia y t\u1ebf trong vi\u1ec7c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh nhi\u1ec5m tr\u00f9ng v\u00e0 th\u00e1i \u0111\u1ed9 x\u1eed tr\u00ed v\u1edbi c\u00e1c \u0111\u00e1p \u1ee9ng vi\u00eam.<\/p>\n<p>C\u00e1c \u0111\u1ed9c gi\u1ea3 c\u00f3 th\u1ec3 truy c\u1eadp v\u00e0o trang web <a href=\"https:\/\/vinmecdr.com\/\">vinmecdr.com<\/a>, \u0111\u1ec3 tham kh\u1ea3o th\u00eam nh\u1eefng b\u00e0i vi\u1ebft chuy\u00ean s\u00e2u v\u1ec1 Neutrophils v\u00e0 h\u1ec7 mi\u1ec5n d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3 con ng\u01b0\u1eddi.<\/p>\n<p><strong>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong><br \/>\nAbul K Abbas, Andrew H. Lichtman, and Shiv Oillai. 2021. Cellular and Molecular Immunology. 10th ed.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Neutrophils l\u00e0 lo\u1ea1i t\u1ebf b\u00e0o b\u1ea1ch c\u1ea7u l\u01b0u h\u00e0nh ph\u1ed5 bi\u1ebfn nh\u1ea5t trong c\u01a1 th\u1ec3. Nh\u1eefng t\u1ebf b\u00e0o n\u00e0y \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch b\u1ea9m sinh v\u00e0 tham gia v\u00e0o giai \u0111o\u1ea1n \u0111\u1ea7u c\u1ee7a vi\u00eam v\u00e0 nhi\u1ec5m tr\u00f9ng. Vai tr\u00f2 c\u1ee7a Neutrophils c\u00e0ng \u0111\u01b0\u1ee3c th\u1ec3 hi\u1ec7n r\u00f5 n\u00e9t trong \u0111\u00e1p [&hellip;]<\/p>\n","protected":false},"author":55,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[73,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Neutrophils: Vai tr\u00f2 th\u1eadt s\u1ef1 trong ph\u1ea3n \u1ee9ng vi\u00eam c\u1ea5p - Vinmec<\/title>\n<meta name=\"description\" content=\"Neutrophils l\u00e0 t\u1ebf b\u00e0o ch\u00ednh trong \u0111\u00e1p \u1ee9ng vi\u00eam c\u1ea5p v\u00e0 c\u00f3 vai tr\u00f2 c\u1ef1c k\u1ef3 quan tr\u1ecdng \u0111\u1ed1i v\u1edbi vi\u1ec7c ch\u1ed1ng l\u1ea1i c\u00e1c vi sinh v\u1eadt x\u00e2m nh\u1eadp.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Neutrophils: Vai tr\u00f2 th\u1eadt s\u1ef1 trong ph\u1ea3n \u1ee9ng vi\u00eam c\u1ea5p - 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