Alert Cell Strategy: Mechanisms of Inflammatory Response and Organ Protection
Alert Cell Strategy: Mechanisms of Inflammatory Response and Organ Protection
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DOI：
10.2174/138161282036140912122809
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发表时间：
2014-01-01
影响因子：
3.1
通讯作者：
Matsuda, Naoyuki
中科院分区：
文献类型：
--
作者：
Hatakeyama, Noboru;Matsuda, Naoyuki
全身炎症反应综合征（SIRS）是由多种因素如外科手术、创伤、烧伤、缺血、胰腺炎和细菌移位等引发的。脓毒症是与细菌感染相关的SIRS。全身炎症反应综合征（SIRS）和脓毒症往往会引发炎性细胞因子和其他炎性分子的过度产生，并诱导多器官功能衰竭，如急性肺损伤、急性肾损伤和炎性心脏损伤。一些主要器官中的上皮和内皮细胞在质膜上表达炎症受体，并作为炎症的警戒细胞，调节这些警戒细胞可对炎症反应具有缓解作用。在炎症性疾病中，初始心功能不全由前负荷降低介导，需要适当的输注治疗。快速性心律失常是炎症性疾病的并发症，早期控制炎症反应可以防止对治疗有抵抗力的结构重塑。此外，在炎症条件下，主要器官之间似乎存在串扰，其中心集中在肾脏上。作为一种警戒细胞策略，挥发性麻醉剂七氟烷和异氟烷似乎具有抗炎作用，实验和临床研究均显示这些药物在各种炎症条件下的有益作用。另一方面，就静脉麻醉剂丙泊酚和氯胺酮而言，其目前的地位仍有争议，因为缺乏证实证据表明它们在炎症条件下是否具有器官保护作用。局部麻醉剂利多卡因抑制全身和局部给药后的炎症反应。为了控制炎性疾病，麻醉剂可能是与其他治疗和药物一致的药物开发的靶点。
Systemic inflammatory response syndrome (SIRS) is triggered by various factors such as surgical operation, trauma, burn injury, ischemia, pancreatitis and bacterial translocation. Sepsis is a SIRS associated with bacterial infection. SIRS and sepsis tend to trigger excessive production of inflammatory cytokines and other inflammatory molecules and induce multiple organ failure, such as acute lung injury, acute kidney injury and inflammatory cardiac injury. Epithelial and endothelial cells in some major organs express inflammatory receptors on the plasma membrane and work as alert cells for inflammation, and regulation of these alert cells could have a relieving effect on the inflammatory response. In inflammatory conditions, initial cardiac dysfunction is mediated by decreased preload and adequate infusion therapy is required. Tachyarrhythmia is a complication of inflammatory conditions and early control of the inflammatory reaction would prevent the structural remodeling that is resistant to therapies. Furthermore, there seems to be crosstalk between major organs with a central focus on the kidneys in inflammatory conditions. As an alert cell strategy, volatile anesthetics, sevoflurane and isoflurane, seem to have anti-inflammatory effects, and both experimental and clinical studies have shown the beneficial effects of these drugs in various settings of inflammatory conditions. On the other hand, in terms of intravenous anesthetics, propofol and ketamine, their current status is still controversial as there is a lack of confirmatory evidence on whether they have an organ-protective effect in inflammatory conditions. The local anesthetic lidocaine suppressed inflammatory responses upon both systemic and local administration. For the control of inflammatory conditions, anesthetic agents may be a target of drug development in accordance with other treatments and drugs.