4th Department of Internal Medicine, University of Athens, Medical School, Athens, Greece.
Expert Rev Anti Infect Ther. 2012 Mar;10(3):369-80. doi: 10.1586/eri.12.2.
The immune response to a bacterial stimulus starts when pathogen-associated molecular patterns of the bacterial pathogens activate pattern recognition receptors of the innate immune system. This leads to production of proinflammatory and anti-inflammatory mediators aiming to contain infection and drive the clinical signs of sepsis. When sepsis and signs of failing organs are apparent, proinflammatory phenomena have ceased; a hypoinflammatory phase predominates, characterized by anergy of monocytes and apoptosis of T lymphocytes. The above sequence of events seems to differ from one patient to the next. The majority of therapies targeting the immune responses have failed to provide clinical benefit. Immunostimulation with IFN-γ and leukocyte growth factors, hemoperfusion with polymyxin B-embedded fiber column, and macrolides remain the most promising immunomodulators in clinical practice.
当细菌病原体的病原体相关分子模式激活先天免疫系统的模式识别受体时，针对细菌刺激的免疫反应就开始了。这导致产生促炎和抗炎介质，旨在控制感染并引发败血症的临床症状。当出现败血症和器官衰竭的迹象时，促炎现象已经停止；以单核细胞无反应性和 T 淋巴细胞凋亡为特征的低炎症期占主导地位。上述事件序列似乎因个体患者而异。针对免疫反应的大多数治疗方法都未能提供临床益处。IFN-γ 和白细胞生长因子的免疫刺激、多粘菌素 B 嵌入纤维柱的血液灌流以及大环内酯类药物仍然是临床实践中最有前途的免疫调节剂。
