Vourc'h Mickael, Roquilly Antoine, Asehnoune Karim
Laboratoire UPRES EA3826 "Thérapeutiques cliniques et expérimentales des infections", IRS2 - Nantes Biotech, Université de Nantes, Nantes, France.
Intensive Care Unit, Anesthesia and Critical Care Department, Hôtel Dieu, University Hospital of Nantes, Nantes, France.
Front Immunol. 2018 Jun 15;9:1330. doi: 10.3389/fimmu.2018.01330. eCollection 2018.
Trauma is one of the leading causes of death and disability in the world. Multiple trauma or isolated traumatic brain injury are both indicative of human tissue damage. In the early phase after trauma, damage-associated molecular patterns (DAMPs) are released and give rise to sterile systemic inflammatory response syndrome (SIRS) and organ failure. Later, protracted inflammation following sepsis will favor hospital-acquired infection and will worsen patient's outcome through immunosuppression. Throughout medical care or surgical procedures, severe trauma patients will be subjected to endogenous or exogenous DAMPs. In this review, we summarize the current knowledge regarding DAMP-mediated SIRS or immunosuppression and the clinical consequences in terms of organ failure and infections.
创伤是全球死亡和残疾的主要原因之一。多发伤或单纯性创伤性脑损伤均表明人体组织受到损伤。在创伤后的早期阶段,损伤相关分子模式(DAMPs)被释放,引发无菌性全身炎症反应综合征(SIRS)和器官衰竭。随后,脓毒症后的持续性炎症会增加医院获得性感染的风险,并通过免疫抑制使患者的预后恶化。在整个医疗或外科手术过程中,严重创伤患者都会受到内源性或外源性DAMPs的影响。在本综述中,我们总结了目前关于DAMPs介导的SIRS或免疫抑制以及器官衰竭和感染方面临床后果的知识。