Wang Yanghanzhao, Zhang Hao, Miao Changhong
Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, China.
Shanghai Key laboratory of Perioperative Stress and Protection, Shanghai, China.
Cell Death Dis. 2025 May 16;16(1):393. doi: 10.1038/s41419-025-07714-w.
Sepsis is a life-threatening multiple organ dysfunction resulting from a dysregulated host response to infection, and patients with sepsis always exhibit a state of immune disorder characterized by both overwhelming inflammation and immunosuppression. The aging of immune system, namely "immunosenescence", has been reported to be correlated with high morbidity and mortality in elderly patients with sepsis. Initially, immunosenescence was considered as a range of age-related alterations in the immune system. However, increasing evidence has proven that persistent inflammation or even a short-term inflammatory challenge during sepsis could trigger accelerated aging of immune cells, which might further exacerbate inflammatory cytokine storm and promote the shift towards immunosuppression. Thus, premature immunosenescence is found in young sepsis individuals, which further aggravates immune disorders and induces the progression of sepsis. Furthermore, in old sepsis patients, the synergistic effects of both sepsis and aging may cause immunosenescence-associated alterations more significantly, resulting in more severe immune dysfunction and a worse prognosis. Therefore, it is necessary to explore the potential therapeutic strategies targeting immunosenescence during sepsis.
脓毒症是由宿主对感染的失调反应导致的危及生命的多器官功能障碍,脓毒症患者总是表现出以过度炎症和免疫抑制为特征的免疫紊乱状态。据报道,免疫系统的衰老,即“免疫衰老”,与老年脓毒症患者的高发病率和死亡率相关。最初,免疫衰老被认为是免疫系统中一系列与年龄相关的变化。然而,越来越多的证据表明,脓毒症期间持续的炎症甚至短期的炎症刺激都可能引发免疫细胞的加速衰老,这可能会进一步加剧炎症细胞因子风暴,并促使向免疫抑制转变。因此,在年轻的脓毒症个体中发现了过早的免疫衰老,这进一步加重了免疫紊乱并促进了脓毒症的进展。此外,在老年脓毒症患者中,脓毒症和衰老的协同作用可能会更显著地导致与免疫衰老相关的改变,从而导致更严重的免疫功能障碍和更差的预后。因此,有必要探索针对脓毒症期间免疫衰老的潜在治疗策略。
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