Hsing Chung-Hsi, Wang Jhi-Joung
Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan; Department of Anesthesiology, Chi-Mei Medical Center, Tainan, Taiwan; Department of Anesthesiology, Taipei Medical University, Taipei, Taiwan.
Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan; Department of Anesthesiology, Chi-Mei Medical Center, Tainan, Taiwan.
Acta Anaesthesiol Taiwan. 2015 Mar;53(1):23-8. doi: 10.1016/j.aat.2015.03.002. Epub 2015 Mar 30.
Cytokines are key modulators of inflammatory responses, and play an important role in the defense and repair mechanisms following trauma. After traumatic injury, an immuno-inflammatory response is initiated immediately, and cytokines rapidly appear and function as a regulator of immunity. In pathologic conditions, imbalanced cytokines may provide systemic inflammatory responses or immunosuppression. Expression of perioperative cytokines vary by different intensities of surgical trauma and types of anesthesia and anesthetic agents. Inflammatory cytokines play important roles in postoperative organ dysfunction including central nervous system, cardiovascular, lung, liver, and kidney injury. Inhibition of cytokines could protect against traumatic injury in some circumstances, therefore cytokine inhibitors or antagonists might have the potential for reducing postoperative tissue/organ dysfunction. Cytokines are also involved in wound healing and post-traumatic pain. Application of cytokines for the improvement of surgical wound healing has been reported. Anesthesia-related immune response adjustment might reduce perioperative morbidity because it reduces proinflammatory cytokine expression; however, the overall effects of anesthetics on postoperative immune-inflammatory responses needs to be further investigated.
细胞因子是炎症反应的关键调节因子，在创伤后的防御和修复机制中发挥重要作用。创伤性损伤后，免疫炎症反应立即启动，细胞因子迅速出现并作为免疫调节剂发挥作用。在病理状态下，细胞因子失衡可能导致全身炎症反应或免疫抑制。围手术期细胞因子的表达因手术创伤的不同强度以及麻醉方式和麻醉药物的类型而异。炎症细胞因子在术后器官功能障碍中起重要作用，包括中枢神经系统、心血管、肺、肝和肾损伤。在某些情况下，抑制细胞因子可预防创伤性损伤，因此细胞因子抑制剂或拮抗剂可能具有减少术后组织/器官功能障碍的潜力。细胞因子还参与伤口愈合和创伤后疼痛。已有报道应用细胞因子改善手术伤口愈合。麻醉相关的免疫反应调节可能会降低围手术期发病率，因为它可减少促炎细胞因子的表达；然而，麻醉药对术后免疫炎症反应的总体影响仍需进一步研究。
