Zivot J B, Hoffman W D
Cleveland Clinic Foundation, Department of General Anesthesiology, OH 44195, USA.
New Horiz. 1995 May;3(2):267-75.
Endotoxin is a lipopolysaccharide contained within the cell wall of Gram-negative bacteria. This molecule initiates a host inflammatory response to Gram-negative bacterial infection. An adequate inflammatory response likely enhances host survival by mediating clearance of infection and bacterial toxins. Unfortunately, this same host response can also produce dysfunction of multiple organ systems and mortality. This article focuses on the history of our understanding of the role of endotoxin in human septic shock. These pathophysiologic connections have led to therapies directed at endotoxin. Unfortunately, antiendotoxin therapy has not achieved significantly improved outcome in humans with severe sepsis. This may represent lack of antiendotoxin efficacy in the compounds used, or a failure of the investigative approach. Interest in antiendotoxin therapies persists, while investigators express more humility in their understanding of endotoxin's role in the pathophysiology of septic shock.
内毒素是革兰氏阴性菌细胞壁中的一种脂多糖。该分子引发宿主对革兰氏阴性菌感染的炎症反应。适当的炎症反应可能通过介导感染和细菌毒素的清除来提高宿主的存活率。不幸的是，同样的宿主反应也可能导致多器官系统功能障碍和死亡。本文重点介绍我们对内毒素在人类脓毒性休克中作用的认识历程。这些病理生理联系催生了针对内毒素的治疗方法。不幸的是，抗内毒素治疗并未显著改善严重脓毒症患者的预后。这可能是因为所用化合物缺乏抗内毒素功效，或者是研究方法存在缺陷。尽管研究人员对脓毒性休克病理生理学中内毒素作用的理解更加谦逊，但对抗内毒素治疗的兴趣依然存在。
