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炎症生物标志物与脓毒症病因学

Biomarkers of inflammation and the etiology of sepsis.

机构信息

Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.

Human Genomics Laboratory, University of Medicine and Pharmacy of Craiova, Craiova, Romania.

出版信息

Biochem Soc Trans. 2020 Feb 28;48(1):1-14. doi: 10.1042/BST20190029.

Abstract

Sepsis is characterized as a life-threatening organ dysfunction syndrome that is caused by a dysregulated host response to infection. The main etiological causes of sepsis are bacterial, fungal, and viral infections. Last decades clinical and preclinical research contributed to a better understanding of pathophysiology of sepsis. The dysregulated host response in sepsis is complex, with both pathogen-related factors contributing to disease, as well as immune-cell mediated inflammatory responses that can lead to adverse outcomes in early or advanced stages of disease. Due to its heterogenous nature, clinical diagnosis remains challenging and sepsis-specific treatment options are still lacking. Classification and early identification of patient subgroups may aid clinical decisions and improve outcome in sepsis patients. The initial clinical presentation is rather similar in sepsis of different etiologies, however, inflammatory profiles may be able to distinguish between different etiologies of infections. In this review, we summarize the role and the discriminating potency of host-derived inflammatory biomarkers in the context of the main etiological types of sepsis.

摘要

脓毒症的特征是一种危及生命的器官功能障碍综合征,由宿主对感染的失调反应引起。脓毒症的主要病因包括细菌、真菌和病毒感染。过去几十年的临床和临床前研究使人们对脓毒症的病理生理学有了更好的理解。脓毒症中失调的宿主反应很复杂,病原体相关因素和免疫细胞介导的炎症反应都可能导致疾病的早期或晚期出现不良后果。由于其异质性,临床诊断仍然具有挑战性,并且仍然缺乏针对脓毒症的特定治疗方法。对患者亚组进行分类和早期识别可能有助于临床决策,并改善脓毒症患者的预后。不同病因引起的脓毒症初始临床表现非常相似,但炎症谱可能能够区分不同病因的感染。在这篇综述中,我们总结了宿主来源的炎症生物标志物在主要病因类型的脓毒症中的作用和区分能力。

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