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发热产生与消退的机制:来自实验性脂多糖发热的经验教训。

Mechanisms of fever production and lysis: lessons from experimental LPS fever.

作者信息

Roth Joachim, Blatteis Clark M

机构信息

Department of Veterinary Physiology and Biochemistry, Justus-Liebig-University, Giessen, Germany; Department of Physiology, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.

出版信息

Compr Physiol. 2014 Oct;4(4):1563-604. doi: 10.1002/cphy.c130033.

Abstract

Fever is a cardinal symptom of infectious or inflammatory insults, but it can also arise from noninfectious causes. The fever-inducing agent that has been used most frequently in experimental studies designed to characterize the physiological, immunological and neuroendocrine processes and to identify the neuronal circuits that underlie the manifestation of the febrile response is lipopolysaccharide (LPS). Our knowledge of the mechanisms of fever production and lysis is largely based on this model. Fever is usually initiated in the periphery of the challenged host by the immediate activation of the innate immune system by LPS, specifically of the complement (C) cascade and Toll-like receptors. The first results in the immediate generation of the C component C5a and the subsequent rapid production of prostaglandin E2 (PGE2). The second, occurring after some delay, induces the further production of PGE2 by induction of its synthesizing enzymes and transcription and translation of proinflammatory cytokines. The Kupffer cells (Kc) of the liver seem to be essential for these initial processes. The subsequent transfer of the pyrogenic message from the periphery to the brain is achieved by neuronal and humoral mechanisms. These pathways subserve the genesis of early (neuronal signals) and late (humoral signals) phases of the characteristically biphasic febrile response to LPS. During the course of fever, counterinflammatory factors, "endogenous antipyretics," are elaborated peripherally and centrally to limit fever in strength and duration. The multiple interacting pro- and antipyretic signals and their mechanistic effects that underlie endotoxic fever are the subjects of this review.

摘要

发热是感染性或炎症性损伤的主要症状,但也可能由非感染性原因引起。在旨在描述生理、免疫和神经内分泌过程以及确定发热反应表现背后的神经回路的实验研究中,最常使用的致热剂是脂多糖(LPS)。我们对发热产生和消退机制的了解很大程度上基于这个模型。发热通常是由LPS立即激活先天免疫系统,特别是补体(C)级联反应和Toll样受体,在受挑战宿主的外周引发的。前者导致补体成分C5a的立即产生以及随后前列腺素E2(PGE2)的快速产生。后者在延迟一段时间后发生,通过诱导其合成酶以及促炎细胞因子的转录和翻译,诱导PGE2的进一步产生。肝脏的库普弗细胞(Kc)似乎对这些初始过程至关重要。随后,致热信息从外周向大脑的传递是通过神经和体液机制实现的。这些途径有助于对LPS特征性双相发热反应的早期(神经信号)和晚期(体液信号)阶段的产生。在发热过程中,抗炎因子,即“内源性解热剂”,在外周和中枢产生,以限制发热的强度和持续时间。内毒素性发热背后的多种相互作用的促热和解热信号及其机制效应是本综述的主题。

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