Wu Dan, Zhang Hao, Miao Changhong
Department of Anesthesiology, Zhongshan Hospital, Fudan University, 180# Feng-Lin Road, Shanghai, 200032, China.
Shanghai Key Laboratory of Perioperative Stress and Protection, 180# Feng-Lin Road, Shanghai, 200032, China.
Burns Trauma. 2025 Jul 15;13:tkaf047. doi: 10.1093/burnst/tkaf047. eCollection 2025.
Sepsis poses a critical threat to global health, mainly due to the disruption of immune homeostasis, which critically influences both early death and long-term adverse outcomes. Current evidence shows that regulatory T (Treg) cells-key mediators of adaptive immunity-play an essential role in maintaining immunological balance during sepsis progression. During the initial hyperinflammatory phase, Treg cells actively suppress excessive inflammation, reducing tissue damage. Paradoxically, in the subsequent immunosuppressive phase, expanded Treg populations may exacerbate immunosuppression by inhibiting effector cell function, ultimately leading to poorer clinical outcomes. Recent research has identified novel Treg-specific biomarkers in sepsis and explained how the septic environment affects Treg cell numbers and function through various signaling pathways. This review combines current understanding of the phenotypic features and roles of Treg cells in sepsis, examines the regulatory mechanisms controlling Treg dynamics within the inflammatory setting, and explores therapeutic strategies targeting Treg cells across different immune phases, emphasizing both existing challenges and future directions.
脓毒症对全球健康构成了严重威胁，主要是由于免疫稳态的破坏，这对早期死亡和长期不良后果都有至关重要的影响。目前的证据表明，调节性T（Treg）细胞——适应性免疫的关键介质——在脓毒症进展过程中维持免疫平衡方面发挥着重要作用。在最初的过度炎症期，Treg细胞积极抑制过度炎症，减少组织损伤。矛盾的是，在随后的免疫抑制期，扩增的Treg细胞群体可能通过抑制效应细胞功能而加剧免疫抑制，最终导致更差的临床结果。最近的研究已经在脓毒症中鉴定出新型的Treg特异性生物标志物，并解释了脓毒症环境如何通过各种信号通路影响Treg细胞数量和功能。这篇综述结合了目前对Treg细胞在脓毒症中的表型特征和作用的理解，研究了炎症环境中控制Treg动态的调节机制，并探索了针对不同免疫阶段Treg细胞的治疗策略，强调了现有的挑战和未来的方向。
