程序性细胞死亡蛋白1/程序性死亡配体1通路:脓毒症的新靶点。

Programmed Cell Death-1/Programmed Death-ligand 1 Pathway: A New Target for Sepsis.

作者信息

Liu Qiang, Li Chun-Sheng

机构信息

Intensive Care Unit, Central Hospital of Dandong City, Dandong, Liaoning 118002; Department of Emergency, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China.

Department of Emergency, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020; Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing 100020, China.

出版信息

Chin Med J (Engl). 2017 Apr 20;130(8):986-992. doi: 10.4103/0366-6999.204113.

Abstract

OBJECTIVE

Sepsis remains a leading cause of death in many Intensive Care Units worldwide. Immunosuppression has been a primary focus of sepsis research as a key pathophysiological mechanism. Given the important role of the negative costimulatory molecules programmed cell death-1 (PD-1) and programmed death-ligand 1 (PD-L1) in the occurrence of immunosuppression during sepsis, we reviewed literatures related to the PD-1/PD-L1 pathway to examine its potential as a new target for sepsis treatment.

DATA SOURCES

Studies of the association between PD-1/PD-L1 and sepsis published up to January 31, 2017, were obtained by searching the PubMed database.

STUDY SELECTION

English language studies, including those based on animal models, clinical research, and reviews, with data related to PD-1/PD-L1 and sepsis, were evaluated.

RESULTS

Immunomodulatory therapeutics could reverse the deactivation of immune cells caused by sepsis and restore immune cell activation and function. Blockade of the PD-1/PD-L1 pathway could reduce the exhaustion of T-cells and enhance the proliferation and activation of T-cells.

CONCLUSIONS

The anti-PD-1/PD-L1 pathway shows promise as a new target for sepsis treatment. This review provides a basis for clinical trials and future studies aimed at revaluating the efficacy and safety of this targeted approach.

摘要

目的

脓毒症仍是全球许多重症监护病房的主要死亡原因。免疫抑制作为关键的病理生理机制,一直是脓毒症研究的主要焦点。鉴于负性共刺激分子程序性细胞死亡蛋白1(PD-1)和程序性死亡配体1(PD-L1)在脓毒症免疫抑制发生过程中的重要作用,我们回顾了与PD-1/PD-L1通路相关的文献,以研究其作为脓毒症治疗新靶点的潜力。

数据来源

通过检索PubMed数据库获取截至2017年1月31日发表的关于PD-1/PD-L1与脓毒症关联的研究。

研究选择

评估了英文研究,包括基于动物模型、临床研究及综述且与PD-1/PD-L1和脓毒症相关的数据。

结果

免疫调节疗法可逆转脓毒症所致免疫细胞的失活,恢复免疫细胞的激活及功能。阻断PD-1/PD-L1通路可减少T细胞耗竭,增强T细胞的增殖与激活。

结论

抗PD-1/PD-L1通路有望成为脓毒症治疗的新靶点。本综述为旨在重新评估这种靶向治疗方法的疗效和安全性的临床试验及未来研究提供了依据。

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