Cell death in sepsis: a matter of how, when, and where.

Cell death in sepsis: a matter of how, when, and where.
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DOI:
10.1186/cc7966
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发表时间:
2009
期刊:
Critical care (London, England)
影响因子:
--
通讯作者:
Schulze-Osthoff K
Schulze-Osthoff K
中科院分区:
其他
文献类型:
--
作者:
Bantel H;Schulze-Osthoff K

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多种组织中的细胞死亡失调与败血症的发病机制密切相关,并导致多器官功能衰竭。脓毒症中的细胞死亡是通过坏死还是凋亡发生,可能取决于细胞类型和疾病阶段,因此是一个激烈争论的问题。虽然淋巴细胞凋亡有助于脓毒症的免疫抑制,但最近的证据表明,肝细胞坏死在脓毒症肝功能障碍患者中占主导地位,并与生存率低相关。这些不同的细胞死亡模式可能对炎症反应有不同的影响,但对治疗干预和疾病结果也至关重要。利用最近可用的细胞死亡血清生物标志物来了解死亡过程的复杂性,可能会导致新的治疗方法,并有助于指导败血症的治疗。
Dysregulated cell death in several tissues is intimately involved in the pathogenesis of sepsis and contributes to multiple organ failure. Whether cell death during sepsis occurs by necrosis or apoptosis may depend on the cell type as well as the disease stage and is therefore a matter of intense debate. While lymphocyte apoptosis contributes to immunosuppression in sepsis, recent evidence suggests that necrosis of hepatocytes predominates in septic patients with liver dysfunction and correlates with poor survival. These distinct modes of cell death might have different consequences for the inflammatory response but are also critical for therapeutic interventions and the disease outcome. Understanding the complexity of death processes employing recently available serum biomarkers of cell death could lead to novel therapeutic approaches and assist in the steering of sepsis treatment.
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