Department of Anesthesiology and Intensive Care, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China.
The Children's Hospital, National Clinical Research Center for Child Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 312000, China.
Chin Med J (Engl). 2024 Jul 5;137(13):1522-1534. doi: 10.1097/CM9.0000000000003097. Epub 2024 May 6.
Sepsis poses a health challenge globally owing to markedly high rates of morbidity and mortality. Despite employing bundle therapy over two decades, approaches including transient organ supportive therapy and clinical trials focusing on signaling pathways have failed in effectively reversing multiple organ failure in patients with sepsis. Prompt and appropriate perioperative management for surgical patients with concurrent sepsis is urgent. Consequently, innovative therapies focusing on remedying organ injuries are necessitated. Cell therapy has emerged as a promising therapeutic avenue for repairing local damage to vital organs and restoring homeostasis during perioperative treatment for sepsis. Given the pivotal role of immune cell responses in the pathogenesis of sepsis, stem cell-based interventions that primarily modulate immune responses by interacting with multiple immune cells have progressed into clinical trials. The strides made in single-cell sequencing and gene-editing technologies have advanced the understanding of disease-specific immune responses in sepsis. Chimeric antigen receptor (CAR)-immune cell therapy offers an intriguing option for the treatment of sepsis. This review provides a concise overview of immune cell therapy, its current status, and the strides made in the context of sepsis research, discussing potential strategies for the management of patients with sepsis during perioperative stages.
由于发病率和死亡率显著较高,脓毒症在全球范围内构成健康挑战。尽管在过去二十年中采用了捆绑治疗,但包括短暂器官支持治疗和专注于信号通路的临床试验在内的方法未能有效逆转脓毒症患者的多器官衰竭。对于同时患有脓毒症的外科手术患者,及时和适当的围手术期管理迫在眉睫。因此,需要关注针对纠正器官损伤的创新疗法。细胞疗法已成为修复重要器官局部损伤和恢复脓毒症围手术期内体内平衡的有前途的治疗途径。鉴于免疫细胞反应在脓毒症发病机制中的关键作用,基于干细胞的干预措施主要通过与多种免疫细胞相互作用来调节免疫反应,已进入临床试验阶段。单细胞测序和基因编辑技术的进步加深了对脓毒症中特定免疫反应的理解。嵌合抗原受体 (CAR)-免疫细胞疗法为脓毒症的治疗提供了一个有趣的选择。本文简要概述了免疫细胞疗法及其在脓毒症研究中的现状和进展,讨论了围手术期脓毒症患者管理的潜在策略。