Infectious Diseases Service, Department of Medicine, Lausanne University Hospital, Epalinges, Switzerland.
Front Immunol. 2019 Feb 27;10:327. doi: 10.3389/fimmu.2019.00327. eCollection 2019.
Myeloid-derived suppressor cells (MDSCs) are immature myeloid cells characterized by their immunosuppressive functions. MDSCs expand during chronic and acute inflammatory conditions, the best described being cancer. Recent studies uncovered an important role of MDSCs in the pathogenesis of infectious diseases along with sepsis. Here we discuss the mechanisms underlying the expansion and immunosuppressive functions of MDSCs, and the results of preclinical and clinical studies linking MDSCs to sepsis pathogenesis. Strikingly, all clinical studies to date suggest that high proportions of blood MDSCs are associated with clinical worsening, the incidence of nosocomial infections and/or mortality. Hence, MDSCs are attractive biomarkers and therapeutic targets for sepsis, especially because these cells are barely detectable in healthy subjects. Blocking MDSC-mediated immunosuppression and trafficking or depleting MDSCs might all improve sepsis outcome. While some key aspects of MDSCs biology need in depth investigations, exploring these avenues may participate to pave the way toward the implementation of personalized medicine and precision immunotherapy for patients suffering from sepsis.
髓系来源的抑制性细胞（MDSCs）是具有免疫抑制功能的未成熟髓系细胞。MDSCs 在慢性和急性炎症状态下扩增，其中最典型的是癌症。最近的研究揭示了 MDSCs 在感染性疾病以及脓毒症发病机制中的重要作用。在这里，我们讨论了 MDSCs 扩增和免疫抑制功能的机制，以及将 MDSCs 与脓毒症发病机制联系起来的临床前和临床研究结果。值得注意的是，迄今为止所有的临床研究都表明，血液 MDSCs 的高比例与临床恶化、医院获得性感染和/或死亡率相关。因此，MDSCs 是脓毒症有吸引力的生物标志物和治疗靶点，特别是因为这些细胞在健康个体中几乎检测不到。阻断 MDSC 介导的免疫抑制和迁移或耗尽 MDSC 都可能改善脓毒症的预后。虽然 MDSC 生物学的某些关键方面需要深入研究，但探索这些途径可能有助于为患有脓毒症的患者实施个体化医学和精准免疫治疗铺平道路。
