Mechanisms of the inflammatory response.
Mechanisms of the inflammatory response.
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DOI：
10.1016/s1521-6896(03)00116-2
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发表时间：
2004-09-01
期刊：
影响因子：
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通讯作者：
Toliver-Kinsky, Tracy
中科院分区：
文献类型：
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作者：
Sherwood, Edward R;Toliver-Kinsky, Tracy
由急性炎症引起的生理变化对麻醉师提出了重大的管理挑战。大手术、创伤、烧伤和败血症都有大量的炎症成分。急性炎症以血管扩张、液体渗出和中性粒细胞浸润为特征。这些过程被一系列细胞内和细胞外因子激活和放大，这些因子紧密协调炎症过程。先天免疫系统对感染或损伤反应迅速。巨噬细胞、自然杀伤细胞、CD8 + T淋巴细胞和嗜中性粒细胞提供对有害因素的早期反应，以遏制和消除有害刺激。适应性免疫应答需要预先暴露于微生物抗原，主要由CD4 + T淋巴细胞介导，并用于进一步放大急性炎症。虽然急性炎症从根本上是有益的，但严重的炎症可促成全身炎症反应综合征。这种综合征的特征是炎症过度，最严重的形式可导致器官损伤、休克和死亡。总的来说，在过去的20年里，我们对炎症的理解大大增加。然而，这些基础科学进步尚未转化为创伤，脓毒症和全身性炎症患者的广泛益处。
The physiological alterations induced by acute inflammation present significant management challenges for anaesthesiologists. Major surgery, trauma, burns and sepsis all have large inflammatory components. Acute inflammation is characterized by vasodilatation, fluid exudation and neutrophil infiltration. These processes are activated and amplified by a series of intracellular and extracellular factors that tightly co-ordinate the inflammatory process. The innate immune system responds rapidly to infection or injury. Macrophages, natural killer cells, CD8 + T-lymphocytes and neutrophils provide an early response to injurious factors in an effort to contain and eliminate harmful stimuli. The adaptive immune response requires prior exposure to microbial antigens, is mediated primarily by CD4 + T-lymphocytes and serves to further amplify acute inflammation. Although acute inflammation is fundamentally beneficial, severe inflammation can precipitate the systemic inflammatory response syndrome. This syndrome is characterized by hyperinflammation and can cause organ injury, shock and death in its most severe forms. Overall, our understanding of inflammation has increased tremendously during the past 20 years. However, these basic science advances have not yet translated into widespread benefit for patients suffering from trauma, sepsis and systemic inflammation.