Bitsadze Victoria, Lazarchuk Arina, Vorobev Alexander, Khizroeva Jamilya, Tretyakova Maria, Makatsariya Natalia, Gashimova Nilufar, Grigoreva Kristina, Tatarintseva Alena, Karpova Anna, Mostovoi Aleksei, Zainulina Marina, Kapanadze Daredzhan, Blbulyan Armen, Kuneshko Nart, Gris Jean-Christophe, Elalamy Ismail, Gerotziafas Grigoris, Makatsariya Alexander
Department of Obstetrics, Gynecology and Perinatal Medicine, The I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Str 8-2, Moscow 119435, Russia.
Vorokhobov City Clinical Hospital No 67, Moscow Healthcare Department, 2/44 Salyama Adilya Str., Moscow 123423, Russia.
Int J Mol Sci. 2025 Apr 1;26(7):3259. doi: 10.3390/ijms26073259.
This article explores systemic inflammatory response syndrome (SIRS), thromboinflammation, and septic shock in fetuses and neonates, offering a comprehensive examination of their pathophysiology, diagnostic criteria, and clinical implications. It identifies SIRS as an exaggerated response to external stress, disrupting the balance between inflammation and adaptive mechanisms, driven by cytokines such as TNF-α and IL-1. The fetal inflammatory response syndrome (FIRS), a subset of SIRS, is noted for its role in adverse neonatal outcomes, including organ damage, inflammation, and long-term developmental disorders. The article discusses the extensive effects of FIRS on critical systems, including the blood, lungs, central nervous system, and kidneys. It highlights the challenges in diagnosing and managing septic shock in neonates, focusing on the relationship between inflammation and the hemostatic system. Additionally, the paper points out recent advancements, such as the convergent model of coagulation and emerging biomarkers like microRNAs for early detection. Despite this progress, gaps remain in understanding the molecular mechanisms underlying these conditions and in developing effective therapeutic strategies. This highlights the necessity for targeted research to mitigate the morbidity and mortality associated with septic shock in neonates.
本文探讨了胎儿和新生儿的全身炎症反应综合征（SIRS）、血栓炎症和感染性休克，全面审视了它们的病理生理学、诊断标准及临床意义。文章将SIRS确定为对外部应激的过度反应，由肿瘤坏死因子-α（TNF-α）和白细胞介素-1（IL-1）等细胞因子驱动，破坏了炎症与适应性机制之间的平衡。胎儿炎症反应综合征（FIRS）作为SIRS的一个子集，因其在不良新生儿结局中的作用而受到关注，这些结局包括器官损伤、炎症和长期发育障碍。本文讨论了FIRS对关键系统（包括血液、肺、中枢神经系统和肾脏）的广泛影响。文章强调了新生儿感染性休克诊断和管理方面的挑战，重点关注炎症与止血系统之间的关系。此外，本文还指出了近期的进展，如凝血的趋同模型以及微小RNA等新兴生物标志物用于早期检测。尽管取得了这些进展，但在理解这些病症的分子机制以及制定有效的治疗策略方面仍存在差距。这凸显了开展针对性研究以降低新生儿感染性休克相关发病率和死亡率的必要性。
