Department of Anesthesiology and Critical Care and Surgery and Sepsis Research Program, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY 11030, USA.
Immunity. 2014 Apr 17;40(4):463-75. doi: 10.1016/j.immuni.2014.04.001.
Sepsis, a clinical syndrome occurring in patients following infection or injury, is a leading cause of morbidity and mortality worldwide. Current immunological mechanisms do not explain the basis of cellular dysfunction and organ failure, the ultimate cause of death. Here we review current dogma and argue that it is time to delineate novel immunometabolic and neurophysiological mechanisms underlying the altered cellular bioenergetics and failure of epithelial and endothelial barriers that produce organ dysfunction and death. These mechanisms might hold the key to future therapeutic strategies.
败血症是一种临床综合征,发生于感染或损伤后的患者,是全球发病率和死亡率的主要原因。目前的免疫机制无法解释细胞功能障碍和器官衰竭的根本原因,即死亡的最终原因。在这里,我们回顾了目前的定论,并认为是时候描绘出改变细胞生物能量和上皮及内皮屏障功能障碍的新的免疫代谢和神经生理学机制了,这些机制可能是未来治疗策略的关键。