From the Veterans Administration San Diego Healthcare System, Department of Anesthesiology, San Diego, California.
Department of Anesthesiology, University of California, San Diego School of Medicine, San Diego, California.
Anesth Analg. 2021 Nov 1;133(5):1162-1179. doi: 10.1213/ANE.0000000000005655.
Extracellular vesicles (EVs) play critical roles in many health and disease states, including ischemia, inflammation, and pain, which are major concerns in the perioperative period and in critically ill patients. EVs are functionally active, nanometer-sized, membrane-bound vesicles actively secreted by all cells. Cell signaling is essential to physiological and pathological processes, and EVs have recently emerged as key players in intercellular communication. Recent studies in EV biology have improved our mechanistic knowledge of the pathophysiological processes in perioperative and critical care patients. Studies also show promise in using EVs in novel diagnostic and therapeutic clinical applications. This review considers the current advances and gaps in knowledge of EVs in the areas of ischemia, inflammation, pain, and in organ systems that are most relevant to anesthesiology, perioperative medicine, critical care, and pain management. We expect the reader will better understand the relationship between EVs and perioperative and critical care pathophysiological states and their potential use as novel diagnostic and therapeutic modalities.
细胞外囊泡（EVs）在许多健康和疾病状态中发挥着关键作用，包括缺血、炎症和疼痛，这些都是围手术期和重症患者的主要关注点。EVs 是具有功能活性的、纳米级大小的、由所有细胞主动分泌的膜结合囊泡。细胞信号转导对于生理和病理过程至关重要，而 EVs 最近已成为细胞间通讯的关键参与者。EV 生物学的最新研究提高了我们对围手术期和重症患者病理生理过程的机制认识。研究还表明，在新型诊断和治疗临床应用中使用 EV 具有广阔的前景。本综述考虑了在缺血、炎症、疼痛以及与麻醉学、围手术期医学、重症监护和疼痛管理最相关的器官系统中 EV 领域的最新进展和知识空白。我们期望读者能够更好地理解 EVs 与围手术期和重症患者病理生理状态之间的关系，以及它们作为新型诊断和治疗方式的潜在用途。
