Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China.
Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China.
Int Immunopharmacol. 2021 Jul;96:107791. doi: 10.1016/j.intimp.2021.107791. Epub 2021 May 29.
Sepsis is a life-threatening clinical syndrome caused by infection. Its pathogenesis is complex and entails coagulation dysfunction, inflammation, and immune disorders. Macrophages are important components of innate and adaptive immunity that are highly heterogeneous and plastic. They can polarize into a multi-dimensional spectrum of phenotypes with different functions relating to immune regulation in response to changes in the microenvironment of specific tissues. We reviewed studies that examined the role of macrophage polarization with a focus on the classical activated (M1-like) and alternative activated (M2-like) macrophages as the two main phenotypes involved in the host immune response to sepsis. A complex regulatory network is involved in the process of macrophage polarization, which is influenced by a variety of signaling molecules, transcription factors, epigenetic modifications, and metabolic reprogramming. M1-like macrophages release large quantities of pro-inflammatory mediators, while M2-like macrophages release large quantities of anti-inflammatory mediators. An imbalance between M1-like and M2-like macrophages induces the occurrence and development of sepsis. Therefore, targeted regulation of the process of macrophage polarization could be a useful approach to normalize the immune balance of the host, offering a new treatment modality for different stages of sepsis.
脓毒症是一种由感染引起的危及生命的临床综合征。其发病机制复杂，涉及凝血功能障碍、炎症和免疫紊乱。巨噬细胞是先天和适应性免疫的重要组成部分，具有高度异质性和可塑性。它们可以在特定组织微环境变化的刺激下，极化成为具有不同功能的多维表型谱，从而参与免疫调节。我们综述了研究巨噬细胞极化作用的文献，重点关注经典激活（M1 样）和替代激活（M2 样）巨噬细胞作为参与宿主对脓毒症免疫反应的两种主要表型。巨噬细胞极化过程涉及复杂的调控网络，受多种信号分子、转录因子、表观遗传修饰和代谢重编程的影响。M1 样巨噬细胞释放大量促炎介质，而 M2 样巨噬细胞释放大量抗炎介质。M1 样和 M2 样巨噬细胞之间的失衡会导致脓毒症的发生和发展。因此，靶向调节巨噬细胞极化过程可能有助于恢复宿主的免疫平衡，为脓毒症的不同阶段提供新的治疗方法。
