Xiong Dacheng, Geng Huixian, Lv Xuechun, Wang Shuqi, Jia Lijing
Department of Intensive Care Medicine, Hebei Medical University, Shijiazhuang, People's Republic of China.
Department of Intensive Care Medicine, Hebei General Hospital, Shijiazhuang, People's Republic of China.
J Inflamm Res. 2025 Feb 14;18:2267-2281. doi: 10.2147/JIR.S504694. eCollection 2025.
Many patients now survive their initial critical events but subsequently develop chronic critical illness (CCI). CCI is characterized by prolonged hospital stays, poor outcomes, and significant long-term mortality. The incidence of chronic critical illness (CCI) is estimated to be 34.4 cases per 100,000 population. The incidence varies significantly with age, peaking at 82.1 cases per 100,000 in individuals aged 75-79. The one-year mortality rate among CCI patients approaches 50%. A subset of these patients enters a state of persistent inflammation, immune suppression, and ongoing catabolism, a condition termed persistent inflammation, immunosuppression, and catabolism syndrome (PICS) in 2012. In recent years, some progress has been made in treating PICS. For instance, recent advancements such as the persistent expansion of MDSCs (myeloid-derived suppressor cells) and the mechanisms underlying intestinal barrier dysfunction have provided new directions for therapeutic strategies, as discussed below. Persistent inflammation, a key feature of PICS, has received comparatively little research attention. In this review, we examine the potential pathophysiological changes and molecular mechanisms underlying persistent inflammation and its role in PICS. We also discuss current therapies about inflammation and offer recommendations for managing patients with PICS.
现在许多患者在经历最初的危急事件后存活下来，但随后发展为慢性危重病（CCI）。慢性危重病的特征是住院时间延长、预后不良以及长期死亡率高。据估计，慢性危重病（CCI）的发病率为每10万人中有34.4例。发病率随年龄显著变化，在75 - 79岁的人群中达到峰值，每10万人中有82.1例。慢性危重病患者的一年死亡率接近50%。这些患者中的一部分进入持续炎症、免疫抑制和持续分解代谢状态，2012年将这种情况称为持续炎症、免疫抑制和分解代谢综合征（PICS）。近年来，在治疗PICS方面取得了一些进展。例如，最近的进展，如骨髓来源的抑制细胞（MDSCs）的持续扩增以及肠道屏障功能障碍的潜在机制，为治疗策略提供了新的方向，如下所述。持续炎症是PICS的一个关键特征，但相对较少受到研究关注。在这篇综述中，我们研究了持续炎症潜在的病理生理变化和分子机制及其在PICS中的作用。我们还讨论了当前针对炎症的治疗方法，并为管理PICS患者提供建议。
