Mechanisms and modulation of sepsis-induced immune dysfunction in children.
Mechanisms and modulation of sepsis-induced immune dysfunction in children.
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DOI：
10.1038/s41390-021-01879-8
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发表时间：
2022-01
影响因子：
3.6
通讯作者：
Coates BM
中科院分区：
文献类型：
--
作者：
Mithal LB;Arshad M;Swigart LR;Khanolkar A;Ahmed A;Coates BM
脓毒症期间的免疫反应在不同患者之间差异很大，并随着病程的推移而演变。由于免疫细胞的产生、成熟、功能和凋亡的不利改变，脓毒症对免疫系统有直接的影响。脓毒症期间先天免疫反应和获得性免疫反应的失调导致一系列表型，包括炎症和免疫抑制，可导致免疫麻痹。在这篇综述中，我们讨论了脓毒症免疫失调的组成部分，生物标记物和功能免疫分析，以帮助患者的免疫表型，以及不断发展的免疫调节治疗。未来的重要研究空白包括：1)确定年龄、宿主因素(包括既往暴露)和遗传学如何影响儿童脓毒症的发病轨迹；2)开发快速评估脓毒症免疫功能的工具；3)评估儿科脓毒症内型演变对免疫调节的不同反应。尽管有多种有希望的免疫调节剂存在或正在开发中，但需要获得快速免疫表型鉴定，以确定哪些儿童最有可能从哪种疗法中受益。在执行多维内分型的能力方面的进步将是为脓毒症儿童开发个性化方法的关键。
Immunologic responses during sepsis vary significantly among patients and evolve over the course of illness. Sepsis has a direct impact on the immune system due to adverse alteration of the production, maturation, function, and apoptosis of immune cells. Dysregulation in both the innate and adaptive immune responses during sepsis leads to a range of phenotypes consisting of both hyperinflammation and immunosuppression that can result in immunoparalysis. In this review, we discuss components of immune dysregulation in sepsis, biomarkers and functional immune assays to aid in immunophenotyping patients, and evolving immunomodulatory therapies. Important research gaps for the future include: 1) Defining how age, host factors including prior exposures, and genetics impact the trajectory of sepsis in children, 2) Developing tools for rapid assessment of immune function in sepsis, and 3) Assessing how evolving pediatric sepsis endotypes respond differently to immunomodulation. Although multiple promising immunomodulatory agents exist or are in development, access to rapid immunophenotyping will be needed to identify which children are most likely to benefit from which therapy. Advancements in the ability to perform multidimensional endotyping will be key to developing a personalized approach to children with sepsis.
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影响因子：
120.7
作者：
Boomer, Jonathan S.;To, Kathleen;Chang, Kathy C.;Takasu, Osamu;Osborne, Dale F.;Walton, Andrew H.;Bricker, Traci L.;Jarman, Stephen D., II;Kreisel, Daniel;Krupnick, Alexander S.;Srivastava, Anil;Swanson, Paul E.;Green, Jonathan M.;Hotchkiss, Richard S.
通讯作者：
Hotchkiss, Richard S.
影响因子：
9.6
作者：
Doughty, L;Carcillo, JA;Janosky, J
通讯作者：
Janosky, J
影响因子：
7.3
作者：
Georgountzou A;Papadopoulos NG
通讯作者：
Papadopoulos NG
影响因子：
120.7
作者：
FISHER, CJ;DHAINAUT, JFA;STABLEIN, D
通讯作者：
STABLEIN, D
影响因子：
6.4
作者：
Gogos, CA;Drosou, E;Skoutelis, A
通讯作者：
Skoutelis, A