Ma Tao, Liu Tong
Department of General Surgery, Tianjin Medical University Cancer Hospital, Tianjin 300052, China.Email:
Department of General Surgery, Tianjin Medical University Cancer Hospital, Tianjin 300052, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2018 Dec 25;21(12):1347-1350.
Despite the evolution of aggressive surgical techniques, extensive methods of supportive care and a vast array of anti-microbial options, intra-abdominal infection (IAI) is still a challenging clinical issue. Especially, when progressed IAI with septic complications because of unbalanced immune responses, the prognosis will deteriorated significantly. Recent studies indicate that besides the natural immunological cells, including macrophages and neutrophils, local immunological characteristics of peritoneal cavity should be studied with great attention. Among them, the omentum is considered to be a visceral adipose tissue with unique immune function. The milky spots(MSs) formed by the accumulation of immune cells performs immune surveillance and has a lymph node-like immune function, which is very important for the immune defense of the abdominal cavity. B1 cells and two types of intrinsic lymphocytes(ILC2) in the peritoneal cavity, although belonging to the lymphatic lineage, may play an important role in abdominal infections, especially in the early stages of the disease, due to their rapid responsiveness and acquired immune function. Therefore, paying attention to the immunological characteristics of the peritoneal cavity, and elucidating the changes, functions and regulatory mechanisms of B1 cells and ILC2 around the MSs and their components in the process of IAI, in order to explore the immunomodulation targets of blocking the infection from local to systemic dissemination, may be the key to solving the clinical problem of severe IAI and improving prognosis.
尽管积极的手术技术不断发展,支持治疗方法广泛且有大量抗菌选择,但腹腔内感染(IAI)仍是一个具有挑战性的临床问题。特别是当IAI进展并伴有因免疫反应失衡导致的脓毒症并发症时,预后会显著恶化。最近的研究表明,除了包括巨噬细胞和中性粒细胞在内的天然免疫细胞外,还应高度关注腹腔的局部免疫特征。其中,大网膜被认为是具有独特免疫功能的内脏脂肪组织。由免疫细胞聚集形成的乳斑(MSs)进行免疫监视并具有类似淋巴结的免疫功能,这对腹腔的免疫防御非常重要。腹腔中的B1细胞和两种固有淋巴细胞(ILC2)虽然属于淋巴谱系,但由于其快速反应性和获得性免疫功能,可能在腹部感染中发挥重要作用,尤其是在疾病早期。因此,关注腹腔的免疫特征,阐明IAI过程中MSs及其组成周围B1细胞和ILC2的变化、功能和调节机制,以探索阻断感染从局部向全身扩散的免疫调节靶点,可能是解决严重IAI临床问题并改善预后的关键。