Kingsley S Manoj Kumar, Bhat B Vishnu
Department of Neonatology, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry 605006, India.
Blood Rev. 2016 Nov;30(6):439-452. doi: 10.1016/j.blre.2016.05.004. Epub 2016 Jun 4.
The severity and threat of sepsis is well known, and despite several decades of research, the mortality continues to be high. Stem cells have great potential to be used in various clinical disorders. The innate ability of stem cells such as pluripotency, self-renewal makes them potential agents for therapeutic intervention. The pathophysiology of sepsis is a plethora of complex mechanisms which include the initial microbial infection, followed by "cytokine storm," endothelial dysfunction, coagulation cascade, and the late phase of apoptosis and immune paralysis which ultimately results in multiple organ dysfunction. Stem cells could potentially alter each step of this complex pathophysiology of sepsis. Multiple organ dysfunction associated with sepsis most often leads to death and stem cells have shown their ability to prevent the organ damage and improve the organ function. The possible mechanisms of therapeutic potential of stem cells in sepsis have been discussed in detail. The route of administration, dose level, and timing also play vital role in the overall effect of stem cells in sepsis.
脓毒症的严重性和威胁众所周知,尽管经过了数十年的研究,其死亡率仍然很高。干细胞在各种临床疾病中具有巨大的应用潜力。干细胞的固有能力,如多能性、自我更新能力,使其成为治疗干预的潜在药物。脓毒症的病理生理学涉及众多复杂机制,包括最初的微生物感染,随后是“细胞因子风暴”、内皮功能障碍、凝血级联反应,以及后期的细胞凋亡和免疫麻痹,最终导致多器官功能障碍。干细胞有可能改变脓毒症这一复杂病理生理学的每一个步骤。与脓毒症相关的多器官功能障碍最常导致死亡,而干细胞已显示出预防器官损伤和改善器官功能的能力。干细胞在脓毒症中的治疗潜力的可能机制已得到详细讨论。给药途径、剂量水平和时间安排在干细胞对脓毒症的整体效果中也起着至关重要的作用。