炎症与感染性嗅觉功能障碍的神经免疫机制及治疗策略

Neuroimmune mechanisms and therapeutic strategies of inflammatory and infectious olfactory dysfunction

摘要

嗅觉系统通过嗅感觉神经元与免疫细胞、支持细胞等复杂互作，维持黏膜屏障稳态并实现嗅觉信号跨层级传递。然而，炎症与感染等病理条件可导致嗅觉功能障碍(olfactory dysfunction, OD)。尽管研究已初步揭示嗅黏膜免疫框架及其与神经元再生的关联，但免疫细胞亚群在疾病进程中的表型转换机制、病原体致病的多途径异质性，以及现有疗法在逆转纤维化重塑与神经突触丢失中的局限性，仍是领域内亟待解决的关键问题。本综述系统解析嗅觉系统解剖与功能基础，聚焦炎症导致OD中的免疫微环境动态失衡，揭示病原体干扰嗅觉信号传导的分子机制，评估现有治疗策略不足，并探讨新兴技术转化潜力，以期为推动嗅觉医学从症状控制向功能重建的范式革新。

Abstract

The olfactory system maintains mucosal barrier homeostasis and enables cross-level transmission of olfactory signals through a complex interplay between olfactory sensory neurons, immune cells and support cells. However, pathological conditions such as inflammation and infection can lead to olfactory dysfunction (OD). Although researches have initially revealed the immunological framework of the olfactory mucosa and its association with neuronal regeneration, significant challenges remain in this area of research. These include the mechanisms by which immune cell subsets change phenotype during disease progression, the multifactorial nature of pathogen-mediated pathogenesis, and the limitations of current therapies in reversing fibrotic remodeling and synaptic loss. This review systematically analyses the anatomical and functional basis of the olfactory system, with a focus on the dynamic imbalance of the immune microenvironment in inflammation-induced OD. It also reveals the molecular mechanisms by which pathogens disrupt olfactory signal transduction and evaluates the limitations of current therapeutic strategies. Furthermore, it explores the potential of emerging technologies for translational research. The ultimate goal is to shift the paradigm of olfactory medicine from symptomatic control to functional restoration.

关键词

嗅觉障碍 / 炎症 / 感染 / 血嗅屏障 / 神经免疫机制

Key words

Olfactory dysfunction / Inflammation / Infection / Blood-olfactory barrier / Neuroimmune mechanisms

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