SIRS and group-B streptococcal sepsis in newborns: Pathogenesis and perspectives in adjunctive therapy
SIRS and group-B streptococcal sepsis in newborns: Pathogenesis and perspectives in adjunctive therapy
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DOI：
10.1016/j.siny.2006.03.003
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发表时间：
2006-10-01
影响因子：
3
通讯作者：
Berner, Reinhard
中科院分区：
文献类型：
--
作者：
Henneke, Philipp;Berner, Reinhard
全身性炎症和疑似全身性感染的临床体征在新生儿医学中很常见。然而，致病性传染性生物体只能偶尔被分离出来。在以前健康的婴儿中，败血症风险较低，B组链球菌（GBS）是最常见的分离株。体外和体内数据表明，来自新生儿的免疫细胞对GBS的抗菌性能受损。相反，在GBS激发后形成大量的炎症介质，并且Toll样受体（TLR）在这种情况下是关键的宿主分子。因此，免疫平衡向炎症、SIRS和脓毒症倾斜。新生儿败血症的辅助治疗需要在不进一步损害细菌清除的情况下调节炎症反应。本文总结了导致脓毒症的病理生理学事件，并提出了连续治疗的分子靶点。(c)2006爱思唯尔有限公司保留所有权利。
Clinical signs of systemic inflammation and suspected systemic infection are common in neonatal medicine. Yet, causative infectious organisms can only infrequently be isolated. In previously healthy infants at low risk of sepsis, group B streptococcus (GBS) is the most common isolate. In vitro and in vivo data suggest that immune cells from newborn infants have impaired antimicrobial properties against GBS. In contrast large amounts of inflammatory mediators are formed upon GBS challenge and Toll-like receptors (TLR) are critical host molecules in this context. Thus, the immune balance tilts towards inflammation, SIRS and sepsis. Adjunctive therapy of neonatal sepsis needs to adjust the inflammatory response without further impairing bacterial clearance. This article summarises the pathophysiological events leading to sepsis and suggests molecular targets for adjunctive therapy. (c) 2006 Elsevier Ltd. All rights reserved.