Cheng Lingxia, Cao Yu, Liu Shihao, Lv Lukai, Zhang Jianjun, Bao Ji, Wang Guan, Xu Ping
Emergency Department, Zigong Fourth People's Hospital, Sichuan, China.
State Key Laboratory of Biotherapy and Cancer Center, Collaborative Innovation Center of Biotherapy, West China Hospital, Sichuan University, Sichuan, China.
Int J Surg. 2025 Jun 23;111(9):6260-89. doi: 10.1097/JS9.0000000000002668.
Sepsis is a life-threatening multi-organ dysfunction caused by the dysregulated systemic inflammatory and immune responses in the host to an infection. Despite continuous advances in the treatment of sepsis, its high morbidity and mortality seriously challenge global public health. Symptomatic treatments are currently applied to sepsis patients, while precise treatments acting on the individualized etiological and pathogenic factors are scant. To address the issue, the present review aims to illustrate the pathogenic mechanisms of Gram-negative bacteria, the immune imbalance of co-existing continuous inflammation and immunosuppression, and the increased susceptibility resulting from the imbalanced gut microbiota. Moreover, we summarized the therapeutic strategies for sepsis and the development of precise treatment acting on sepsis patients' individualized subphenotypes and immune statuses. From the perspectives of etiological factors, pathogenesis, and precision treatment, we provide new insights into the future treatment of sepsis.
脓毒症是由宿主对感染的系统性炎症和免疫反应失调引起的危及生命的多器官功能障碍。尽管脓毒症治疗不断取得进展，但其高发病率和死亡率严重挑战全球公共卫生。目前脓毒症患者采用对症治疗，而针对个体化病因和致病因素的精准治疗却很少。为解决这一问题，本综述旨在阐述革兰氏阴性菌的致病机制、持续炎症和免疫抑制并存的免疫失衡以及肠道微生物群失衡导致的易感性增加。此外，我们总结了脓毒症的治疗策略以及针对脓毒症患者个体化亚表型和免疫状态的精准治疗进展。从病因、发病机制和精准治疗的角度，我们为脓毒症的未来治疗提供了新的见解。
