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急性呼吸窘迫综合征细胞因子研究进展:综述

Progress in cytokine research for ARDS: A comprehensive review.

作者信息

Zhou Kaihuan, Lu Junyu

机构信息

Intensive Care Unit, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530007, China.

Intensive Care Unit, The Second Affiliated Hospital of Guangxi Medical University, No. 166 Daxuedong Road, Nanning, Guangxi 530007, China.

出版信息

Open Med (Wars). 2024 Oct 28;19(1):20241076. doi: 10.1515/med-2024-1076. eCollection 2024.

Abstract

INTRODUCTION

Acute respiratory distress syndrome (ARDS) is a critical form of acute respiratory failure characterized by diffuse alveolar damage, refractory hypoxemia, and non-cardiogenic pulmonary edema, resulting in high mortality. Dysregulated inflammation, driven by cytokines, is central to ARDS pathogenesis, progression, and prognosis.

OBJECTIVE

This review synthesizes current knowledge on the role of cytokines in ARDS and evaluates their potential as therapeutic targets, offering new insights for clinical management.

METHODS

A comprehensive analysis of recent studies was conducted to explore the roles of pro-inflammatory cytokines (e.g., IL-1β, IL-6, IL-8) and anti-inflammatory cytokines (e.g., IL-10, IL-22) in ARDS pathogenesis and to assess current and emerging therapies targeting these cytokines.

RESULTS

Pro-inflammatory cytokines are crucial in initiating inflammatory responses and lung injury in early ARDS, while anti-inflammatory cytokines help regulate and resolve inflammation. Targeted therapies, such as IL-1 and IL-6 inhibitors, show potential in managing ARDS, particularly in COVID-19, but their clinical efficacy is still debated. Combination therapy strategies may enhance outcomes, but further large-scale, multicenter randomized controlled trials are required to establish their safety and efficacy.

CONCLUSION

Understanding cytokine regulation in ARDS could lead to innovative therapeutic approaches. Future research should focus on cytokine roles across ARDS subtypes and stages and develop biomarker-driven, individualized treatments.

摘要

引言

急性呼吸窘迫综合征(ARDS)是急性呼吸衰竭的一种严重形式,其特征为弥漫性肺泡损伤、难治性低氧血症和非心源性肺水肿,导致高死亡率。由细胞因子驱动的炎症失调是ARDS发病机制、进展和预后的核心。

目的

本综述综合了关于细胞因子在ARDS中作用的现有知识,并评估它们作为治疗靶点的潜力,为临床管理提供新见解。

方法

对近期研究进行全面分析,以探讨促炎细胞因子(如IL-1β、IL-6、IL-8)和抗炎细胞因子(如IL-10、IL-22)在ARDS发病机制中的作用,并评估针对这些细胞因子的现有和新兴疗法。

结果

促炎细胞因子在早期ARDS引发炎症反应和肺损伤中起关键作用,而抗炎细胞因子有助于调节和消退炎症。靶向治疗,如IL-1和IL-6抑制剂,在管理ARDS方面显示出潜力,尤其是在COVID-19中,但它们的临床疗效仍存在争议。联合治疗策略可能会改善治疗结果,但需要进一步的大规模、多中心随机对照试验来确定其安全性和有效性。

结论

了解ARDS中的细胞因子调节可能会带来创新的治疗方法。未来的研究应关注细胞因子在ARDS各亚型和阶段中的作用,并开发基于生物标志物的个体化治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d03/11524396/cc200dfa4940/j_med-2024-1076-fig001.jpg

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