Institute for Clinical and Experimental Trauma Immunology (ITI), University Hospital Ulm, Helmholtzstr. 8/1, 89081, Ulm, Germany.
Eur J Trauma Emerg Surg. 2022 Dec;48(6):4431-4444. doi: 10.1007/s00068-022-02026-6. Epub 2022 Jul 14.
Polytrauma is often accompanied by ischaemia-reperfusion injury to tissues and organs, and the resulting series of immune inflammatory reactions are a major cause of death in patients. The liver is one of the largest organs in the body, a characteristic that makes it the most vulnerable organ after multiple injuries. In addition, the liver is an important digestive organ that secretes a variety of inflammatory mediators involved in local as well as systemic immune inflammatory responses. Therefore, this review considers the main features of post-traumatic liver injury, focusing on the immuno-pathophysiological changes, the interactions between liver organs, and the principles of treatment deduced.
We focus on the local as well as systemic immune response involving the liver after multiple injuries, with emphasis on the pathophysiological mechanisms.
An overview of the mechanisms underlying the pathophysiology of local as well as systemic immune responses involving the liver after multiple injuries, the latest research findings, and the current mainstream therapeutic approaches.
Cross-reactivity between various organs and cascade amplification effects are among the main causes of systemic immune inflammatory responses after multiple injuries. For the time being, the pathophysiological mechanisms underlying this interaction remain unclear. Future work will continue to focus on identifying potential signalling pathways as well as target genes and intervening at the right time points to prevent more severe immune inflammatory responses and promote better and faster recovery of the patient.
多发伤常伴有组织和器官的缺血再灌注损伤,由此产生的一系列免疫炎症反应是导致患者死亡的主要原因。肝脏是人体最大的器官之一,这一特点使其成为多发性损伤后最脆弱的器官。此外,肝脏是一个重要的消化器官,它分泌多种炎症介质,参与局部和全身免疫炎症反应。因此,本综述考虑了创伤后肝损伤的主要特征,重点讨论了免疫病理生理学变化、肝器官间的相互作用以及推导出的治疗原则。
我们重点关注多发性损伤后涉及肝脏的局部和全身免疫反应,强调病理生理学机制。
概述了涉及多发性损伤后肝脏局部和全身免疫反应的病理生理学机制、最新研究发现以及当前主流的治疗方法。
各种器官之间的交叉反应和级联放大效应是多发性损伤后全身免疫炎症反应的主要原因之一。目前,这种相互作用的病理生理学机制尚不清楚。未来的工作将继续集中于确定潜在的信号通路以及目标基因,并在适当的时间点进行干预,以防止更严重的免疫炎症反应,并促进患者更好更快地康复。