IBSAL-University Hospital of Salamanca, Salamanca, Spain.
Department of Medicine, University of Salamanca, Salamanca, Spain.
Clin Transl Med. 2023 Jan;13(1):e1163. doi: 10.1002/ctm2.1163.
Despite notable advances in the support and treatment of patients admitted to the intensive care unit (ICU), the management of those who develop a systemic inflammatory response syndrome (SIRS) still constitutes an unmet medical need.
Both the initial injury (trauma, pancreatitis, infections) and the derived uncontrolled response promote a hyperinflammatory status that leads to systemic hypotension, tissue hypoperfusion and multiple organ failure. Mesenchymal stromal/stem cells (MSCs) are emerging as a potential therapy for severe ICU patients due to their potent immunomodulatory, anti-inflammatory, regenerative and systemic homeostasis-regulating properties. MSCs have demonstrated clinical benefits in several inflammatory-based diseases, but their role in SIRS needs to be further explored.
In the current review, after briefly overviewing SIRS physiopathology, we explore the potential mechanisms why MSC therapy could aid in the recovery of this condition and the pre-clinical and early clinical evidence generated to date.
尽管重症监护病房(ICU)患者的支持和治疗取得了显著进展,但对于出现全身炎症反应综合征(SIRS)的患者的管理仍然是一个未满足的医疗需求。
初始损伤(创伤、胰腺炎、感染)和由此产生的失控反应都会导致过度炎症状态,从而导致全身低血压、组织灌注不足和多器官衰竭。间充质基质/干细胞(MSCs)由于其强大的免疫调节、抗炎、再生和全身稳态调节特性,正成为严重 ICU 患者的一种潜在治疗方法。MSCs 在几种炎症性疾病中显示出临床益处,但它们在 SIRS 中的作用仍需进一步探索。
在当前的综述中,在简要概述 SIRS 病理生理学之后,我们探讨了为什么 MSC 治疗可能有助于恢复这种情况的潜在机制,以及迄今为止产生的临床前和早期临床证据。