New approaches to the study of sepsis.

New approaches to the study of sepsis.
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DOI:
10.1002/emmm.201201375
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发表时间:
2012-12
影响因子:
11.1
通讯作者:
Ward, Peter A.
Ward, Peter A.
中科院分区:
医学1区
文献类型:
--
作者:
Ward, Peter A.

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脓毒症模型对于理解动物中的事件顺序以及在一定程度上理解患有脓毒症的人类中的事件顺序具有指导意义。脓毒症早期发生的事件表明存在炎症过度状态,伴随着组织中氧化剂的积累,反映了氧化还原失衡。免疫抑制和先天性和适应性免疫应答下降的发展是脓毒症的公认并发症。此外,存在补体系统的强烈激活,这有助于脓毒症的有害影响。这些事件似乎与多器官衰竭的发生相关。脓毒症的动物模型的相关性,人类脓毒症和人类临床试验的失败进行了讨论,以及如何改进临床试验设计的建议。
Models of sepsis have been instructive in understanding the sequence of events in animals and, to an extent, in humans with sepsis. Events developing early in sepsis suggest that a hyperinflammatory state exists, accompanied by a buildup of oxidants in tissues reflective of a redox imbalance. Development of immunosuppression and degraded innate and adaptive immune responses are well-established complications of sepsis. In addition, there is robust activation of the complement system, which contributes to the harmful effects of sepsis. These events appear to be associated with development of multiorgan failure. The relevance of animal models of sepsis to human sepsis and the failure of human clinical trials are discussed, together with suggestions as to how clinical trial design might be improved.
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