Center for Immunology and Inflammation, The Feinstein Institutes for Medical Research, Manhasset, New York, USA.
Departments of Surgery and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, USA.
Antioxid Redox Signal. 2021 Nov 20;35(15):1308-1323. doi: 10.1089/ars.2021.0008. Epub 2021 Mar 30.
Sepsis is defined as a life-threatening organ dysfunction caused by dysregulated host response to infection. This leads to an uncontrolled inflammatory response at the onset of infection, followed by immunosuppression. The development of a specific treatment modality for sepsis is still challenging, reflecting our inadequate understanding of its pathophysiology. Understanding the mechanism and transition of the early hyperinflammation to late stage of immunosuppression in sepsis is critical for developing sepsis therapeutics. Damage-associated molecular patterns (DAMPs) are intracellular molecules and released upon tissue injury and cell death in sepsis. DAMPs are recognized by pattern recognition receptors to initiate inflammatory cascades. DAMPs not only elicit an inflammatory response but also they subsequently induce immunosuppression, both are equally important for exacerbating sepsis. Recent advances on a new DAMP, extracellular cold-inducible RNA-binding protein for fueling inflammation and immunosuppression in sepsis, have added a new avenue into the dual functions of DAMPs in sepsis. The molecular modification of DAMPs and their binding to pattern recognition receptors transit dynamically by the cellular environment in pathophysiologic conditions. Correlation between the dynamic changes of the impacts of DAMPs and the clinical outcomes in sepsis still lacks adequate understanding. Here, we focus on the impacts of DAMPs that cause inflammation as well as induce immunosuppression in sepsis. We further discuss the therapeutic potential by targeting DAMPs to attenuate inflammation and immunosuppression for mitigating sepsis. Uncovering pathways of the transition from inflammation to immunosuppression of DAMPs is a potential therapeutic avenue for mitigating sepsis.
脓毒症定义为感染引起的宿主反应失调导致的危及生命的器官功能障碍。这会导致感染时炎症反应失控,随后出现免疫抑制。目前,脓毒症的特定治疗方法仍具有挑战性,这反映出我们对其病理生理学的理解不足。了解脓毒症中早期过度炎症向晚期免疫抑制的发展机制和转变对于开发脓毒症治疗方法至关重要。
损伤相关分子模式(DAMPs)是细胞内分子,在脓毒症中组织损伤和细胞死亡时释放。DAMPs被模式识别受体识别,从而引发炎症级联反应。DAMPs 不仅引发炎症反应,还随后诱导免疫抑制,这两者对于加重脓毒症同样重要。最近在一种新的 DAMPs(细胞外冷诱导 RNA 结合蛋白)方面的进展,该 DAMPs 促进脓毒症中的炎症和免疫抑制,为 DAMPs 在脓毒症中的双重功能增加了一个新途径。
在病理生理条件下,DAMPs 的分子修饰及其与模式识别受体的结合通过细胞环境动态变化。DAMPs 影响的动态变化与脓毒症临床结局之间的相关性仍缺乏充分理解。在这里,我们重点关注 DAMPs 引起炎症和诱导免疫抑制的影响。我们进一步讨论通过靶向 DAMPs 减轻炎症和免疫抑制以减轻脓毒症的治疗潜力。
揭示 DAMPs 从炎症向免疫抑制转变的途径是减轻脓毒症的潜在治疗途径。