Department of Pathology, University of Iowa, Iowa City, IA.
Interdisciplinary Program in Immunology, University of Iowa, Iowa City, IA.
J Immunol. 2023 Sep 1;211(5):711-719. doi: 10.4049/jimmunol.2300171.
The immunological hallmarks of sepsis include the inflammation-mediated cytokine storm, apoptosis-driven lymphopenia, and prolonged immunoparalysis. Although early clinical efforts were focused on increasing the survival of patients through the first phase, studies are now shifting attention to the long-term effects of sepsis on immune fitness in survivors. In particular, the most pertinent task is deciphering how the immune system becomes suppressed, leading to increased incidence of secondary infections. In this review, we introduce the contribution of numerical changes and functional reprogramming within innate (NK cells, dendritic cells) and adaptive (T cells, B cells) immune cells on the chronic immune dysregulation in the septic murine and human host. We briefly discuss how prior immunological experience in murine models impacts sepsis severity, immune dysfunction, and clinical relevance. Finally, we dive into how comorbidities, specifically autoimmunity and cancer, can influence host susceptibility to sepsis and the associated immune dysfunction.
脓毒症的免疫学特征包括炎症介导的细胞因子风暴、凋亡驱动的淋巴细胞减少和免疫麻痹延长。虽然早期的临床努力主要集中在通过第一阶段提高患者的生存率，但现在的研究注意力正在转移到脓毒症对幸存者免疫适应性的长期影响上。特别是，最重要的任务是破译免疫系统如何受到抑制，导致继发感染的发生率增加。在这篇综述中，我们介绍了固有（NK 细胞、树突状细胞）和适应性（T 细胞、B 细胞）免疫细胞内数量变化和功能重编程对脓毒症小鼠和人类宿主慢性免疫失调的贡献。我们简要讨论了小鼠模型中先前的免疫经验如何影响脓毒症的严重程度、免疫功能障碍和临床相关性。最后，我们深入探讨了合并症，特别是自身免疫和癌症，如何影响宿主对脓毒症的易感性和相关的免疫功能障碍。
