Schäffer M, Barbul A
Department of Surgery, Eberhard Karls Universität, Tübingen, Germany.
Br J Surg. 1998 Apr;85(4):444-60. doi: 10.1046/j.1365-2168.1998.00734.x.
Injury activates a cascade of local and systemic immune responses.
A literature review was undertaken of lymphocyte function in wound healing and following injury.
Lymphocytes are not required for the initiation of wound healing, but an intact cellular immune response is essential for a normal outcome of tissue repair. Injury affects lymphocyte immune mechanisms leading to generalized immunosuppression which, in turn, increases host susceptibility to infection and sepsis. Although the exact origin of post-traumatic immunosuppression remains unknown, stress hormones and immunosuppressive factors, such as inflammatory cytokines, prostaglandin E2 and nitric oxide, affect lymphocyte function adversely. Post-traumatic impairment of T lymphocyte immune function is reflected in decreased lymphocyte numbers, as well as altered T cell phenotype and activity. Antibody-producing B lymphocytes are variably affected by injury, probably secondary to alterations of T lymphocyte function, as a result of their close interaction with helper T cells. Therapeutic modulation of the host immune response may include non-specific and specific interventions to improve overall defence mechanisms.
Early resuscitation to restore lymphocyte function after injury is important for tissue repair and the prevention of immunosuppression.
损伤会激活一系列局部和全身免疫反应。
对淋巴细胞在伤口愈合及损伤后的功能进行了文献综述。
伤口愈合的起始阶段并不需要淋巴细胞,但完整的细胞免疫反应对于组织修复的正常结局至关重要。损伤会影响淋巴细胞免疫机制,导致全身性免疫抑制,进而增加宿主对感染和脓毒症的易感性。尽管创伤后免疫抑制的确切起源尚不清楚,但应激激素和免疫抑制因子,如炎性细胞因子、前列腺素E2和一氧化氮,会对淋巴细胞功能产生不利影响。创伤后T淋巴细胞免疫功能受损表现为淋巴细胞数量减少,以及T细胞表型和活性改变。产生抗体的B淋巴细胞受损伤的影响各不相同,这可能继发于T淋巴细胞功能的改变,因为它们与辅助性T细胞密切相互作用。宿主免疫反应的治疗性调节可能包括非特异性和特异性干预措施,以改善整体防御机制。
损伤后早期进行复苏以恢复淋巴细胞功能对于组织修复和预防免疫抑制很重要。