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脓毒症管理的范式转变:叙事性综述。

Evolving Paradigms in Sepsis Management: A Narrative Review.

机构信息

Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu 41404, Republic of Korea.

Department of Anesthesiology and Pain Medicine, School of Medicine, Daegu Catholic University, Daegu 42472, Republic of Korea.

出版信息

Cells. 2024 Jul 9;13(14):1172. doi: 10.3390/cells13141172.

Abstract

Sepsis, a condition characterized by life-threatening organ dysfunction due to a dysregulated host response to infection, significantly impacts global health, with mortality rates varying widely across regions. Traditional therapeutic strategies that target hyperinflammation and immunosuppression have largely failed to improve outcomes, underscoring the need for innovative approaches. This review examines the development of therapeutic agents for sepsis, with a focus on clinical trials addressing hyperinflammation and immunosuppression. It highlights the frequent failures of these trials, explores the underlying reasons, and outlines current research efforts aimed at bridging the gap between theoretical advancements and clinical applications. Although personalized medicine and phenotypic categorization present promising directions, this review emphasizes the importance of understanding the complex pathogenesis of sepsis and developing targeted, effective therapies to enhance patient outcomes. By addressing the multifaceted nature of sepsis, future research can pave the way for more precise and individualized treatment strategies, ultimately improving the management and prognosis of sepsis patients.

摘要

脓毒症是一种因宿主对感染的反应失调而导致危及生命的器官功能障碍的疾病,对全球健康产生重大影响,不同地区的死亡率差异很大。针对过度炎症和免疫抑制的传统治疗策略在很大程度上未能改善预后,这突显了需要创新方法。本综述探讨了脓毒症治疗药物的发展,重点关注针对过度炎症和免疫抑制的临床试验。它突出了这些试验经常失败的情况,探讨了背后的原因,并概述了当前旨在弥合理论进展和临床应用之间差距的研究工作。尽管个性化医学和表型分类呈现出有前途的方向,但本综述强调了理解脓毒症复杂发病机制并开发靶向、有效的治疗方法以提高患者预后的重要性。通过解决脓毒症的多方面性质,未来的研究可以为更精确和个体化的治疗策略铺平道路,最终改善脓毒症患者的管理和预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d25/11274781/c5cf8fffc48c/cells-13-01172-g001.jpg

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