Toxicology Division, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Poojapura, Trivandrum 695 012, Kerala, India.
Toxicology Division, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Poojapura, Trivandrum 695 012, Kerala, India.
Immunol Lett. 2018 Dec;204:38-46. doi: 10.1016/j.imlet.2018.10.006. Epub 2018 Oct 15.
Fever is one of the cardinal symptoms of onset of an infection or inflammation and is the common clinical indicator for medical consultation in mammalian host worldwide. Simply, fever manifested with elevation of body temperature from normal physiological range represents adaptive response of immune system on challenge with an infectious and non-infectious circumstance. Fever usually initiated in the periphery as a result of interaction of immune cells with exogenous or endogenous pyrogens. Peripheral pyrogenic signals gain access to the central nervous system via humoral and neural route. Humoral pathway was initiated with production of pyrogenic cytokines and prostaglandins from immune cells of blood as well as liver, transmitted directly to pre-optic area of hypothalamus through the circumventricular organ of brain. On the other hand an alternative pathway was initiated by the same cytokines indirectly via stimulating the vagal sensory neurons result in pyrogenic fever; so-called neuronal pathway. If the magnitude of pyrogens associated fever is very high, it will lead to severe illness ranging from septic shock to death. So it is necessary to evaluate the presence of pyrogens in implants, medical devices, drugs and biological materials to ensure safety in biomedical applications and therapeutics. Classification, route of administration, mechanism of action and detection of pyrogens and associated products are the major subject of this review.
发热是感染或炎症发作的主要症状之一，也是全球哺乳动物宿主寻求医疗咨询的常见临床指征。简单来说，发热表现为体温从正常生理范围升高，代表免疫系统对感染和非感染性环境挑战的适应性反应。发热通常在外周开始，是由于免疫细胞与外源性或内源性热原相互作用的结果。外周热原信号通过体液和神经途径进入中枢神经系统。体液途径是通过血液和肝脏中的免疫细胞产生致热细胞因子和前列腺素开始的，直接通过脑的室周器官传递到下丘脑的视前区。另一方面，同样的细胞因子通过刺激迷走感觉神经元间接启动替代途径，导致发热，即所谓的神经元途径。如果与发热相关的热原数量非常高，将导致从感染性休克到死亡等严重疾病。因此，有必要评估植入物、医疗器械、药物和生物材料中热原的存在，以确保在生物医学应用和治疗中的安全性。本综述的主要内容包括热原的分类、给药途径、作用机制以及检测和相关产品。
