Fu Xuzhe, Liu Zhi, Wang Yu
Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China.
Department of Ophthalmology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China.
J Inflamm Res. 2023 Sep 8;16:3967-3981. doi: 10.2147/JIR.S426007. eCollection 2023.
Sepsis is a life-threatening disease caused by a systemic infection that triggers a dysregulated immune response. Sepsis is an important cause of death in intensive care units (ICUs), poses a major threat to human health, and is a common cause of death in ICUs worldwide. The pathogenesis of sepsis is intricate and involves a complex interplay of pro- and anti-inflammatory mechanisms that can lead to excessive inflammation, immunosuppression, and potentially long-term immune disorders. Recent evidence highlights the importance of immunosuppression in sepsis. Immunosuppression is recognized as a predisposing factor for increased susceptibility to secondary infections and mortality in patients. Immunosuppression due to sepsis increases a patient's chance of re-infection and increases organ load. In addition, antibiotics, fluid resuscitation, and organ support therapy have limited impact on the prognosis of septic patients. Therapeutic approaches by suppressing excessive inflammation have not achieved the desired results in clinical trials. Research into immunosuppression has brought new hope for the treatment of sepsis, and a number of therapeutic approaches have demonstrated the potential of immunostimulatory therapies. In this article, we will focus on the mechanisms of immunosuppression and markers of immune monitoring in sepsis and describe various targets for immunostimulatory therapy in sepsis.
脓毒症是一种由全身感染引发免疫反应失调所致的危及生命的疾病。脓毒症是重症监护病房(ICU)患者死亡的重要原因,对人类健康构成重大威胁,是全球ICU患者常见的死亡原因。脓毒症的发病机制错综复杂,涉及促炎和抗炎机制的复杂相互作用,可导致过度炎症、免疫抑制以及潜在的长期免疫紊乱。近期证据凸显了免疫抑制在脓毒症中的重要性。免疫抑制被认为是患者继发感染易感性增加和死亡率上升的一个诱发因素。脓毒症所致的免疫抑制增加了患者再次感染的几率,并增加了器官负担。此外,抗生素、液体复苏和器官支持治疗对脓毒症患者的预后影响有限。通过抑制过度炎症的治疗方法在临床试验中并未取得理想效果。对免疫抑制的研究为脓毒症的治疗带来了新希望,一些治疗方法已显示出免疫刺激疗法的潜力。在本文中,我们将聚焦脓毒症中免疫抑制的机制和免疫监测标志物,并描述脓毒症免疫刺激治疗的各种靶点。