小儿热损伤的全身免疫反应。
The systemic immune response to pediatric thermal injury.
作者信息
Devine Racheal A, Diltz Zachary, Hall Mark W, Thakkar Rajan K
机构信息
Center for Clinical and Translation Research, The Research Institute at Nationwide Children's Hospital700 Children's Drive, Columbus 43205, OH.
The Ohio State University College of Medicine370 W 9th Ave, Columbus 43210, OH.
出版信息
Int J Burns Trauma. 2018 Feb 5;8(1):6-16. eCollection 2018.
BACKGROUND
The immune response to critical injury, including thermal injury, can heavily influence the recovery and long term prognosis for patients suffering such insults. A growing body of evidence supports that a suppressed immunologic state following critical injury can lead to adverse outcomes for adult and pediatric patients.
METHODS
A Pubmed literature search was conducted to review areas of the immune system that are impaired after thermal injury and identify key immune players that are potential targets for therapeutic intervention. The focus was pediatric thermal injury; however, where pediatric studies were lacking adult studies were used as reference.
RESULTS
Changes in cytokine profiles and immune cell phenotypes have been observed following thermal injury. Treatment with immunomodulatory stimulants, including IL-7 and GM-CSF, lead to improved outcomes in critically ill patients and may also be useful tools to improve immune function in pediatric burn patients.
CONCLUSIONS
The innate and adaptive branches of the systemic immune system are impaired following thermal injury in adult and pediatric patients. Immunomodulatory therapies currently being used in areas outside of thermal injury may be useful tools to help improve outcomes following pediatric thermal injury.
背景
对包括热损伤在内的严重创伤的免疫反应，会严重影响遭受此类创伤患者的恢复及长期预后。越来越多的证据表明，严重创伤后免疫状态受到抑制会给成年和儿科患者带来不良后果。
方法
进行了一项PubMed文献检索，以回顾热损伤后免疫系统受损的领域，并确定作为治疗干预潜在靶点的关键免疫因子。重点是儿科热损伤；然而，在缺乏儿科研究的情况下，以成人研究作为参考。
结果
热损伤后观察到细胞因子谱和免疫细胞表型的变化。用免疫调节刺激剂（包括白细胞介素-7和粒细胞巨噬细胞集落刺激因子）进行治疗，可使重症患者的预后得到改善，也可能是改善儿科烧伤患者免疫功能的有用工具。
结论
成年和儿科患者热损伤后，全身免疫系统的固有免疫和适应性免疫分支均受损。目前在热损伤以外领域使用的免疫调节疗法，可能是有助于改善儿科热损伤后预后的有用工具。
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