Epinephrine, Cortisol, Endotoxin, Nutrition, and the Neutrophil
Epinephrine, Cortisol, Endotoxin, Nutrition, and the Neutrophil
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DOI：
10.1089/sur.2012.161
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发表时间：
2012-10-01
影响因子：
2
通讯作者：
Davis, John Mihran
中科院分区：
文献类型：
--
作者：
Parks, Kevin Ryan;Davis, John Mihran
背景：中性粒细胞损伤后的功能障碍在动物和人类中已有文献记载。方法：回顾相关英文文献。结果：在接受完全肠外营养的志愿者中，中性粒细胞对白三烯B4表现出强烈的反应，而对酵母多糖/激活血清或细菌代谢物甲酰-甲硫基-亮氨酰-苯丙氨酸(FMLP)无反应。这一发现表明，在肠道喂养期间不会发生的亚临床暴露于激活的补体和FMLP。中性粒细胞激活的另一个证据是乳铁蛋白在两种喂养途径中的释放程度相同。当正常志愿者受到内毒素攻击时，除LTB4外，中性粒细胞对趋化刺激的反应一致受损。肾上腺素在几小时内增加循环中的中性粒细胞总数，而皮质醇注射后，中性粒细胞计数在6小时内继续增加。肾上腺素和皮质醇联合应用可延长中性粒细胞的半衰期。还回顾了基因组和中枢神经系统通过迷走神经控制的作用。结论：正常志愿者对感染的应激反应提供了洞察力，但对此仅有部分了解。
Background: Neutrophil dysfunction has been documented after injury in animals and human beings. This review evaluates the relative effects of the hormonal and endotoxin response to injury on immune resistance.Method: Review of the pertinent English-language literature.Results: In volunteers given total parenteral nutrition, neutrophils demonstrate a robust response to leukotriene B4 but none to zymosan/activated serum or the bacterial metabolite formyl-methionyl-leucyl-phenylalanine (FMLP). This finding suggests subclinical exposure to activated complement and FMLP that does not occur during enteral feeding. Additional evidence of neutrophil activation is the release of lactoferrin to the same degree with the two routes of feeding. When normal volunteers are challenged with endotoxin, uniform impairment of the neutrophil response to chemotactic stimuli except LTB4 is demonstrated. Epinephrine increases the total circulating neutrophil pool for a few hours, whereas when cortisol is administered, the neutrophil counts continue to increase through 6 h. A combined epinephrine and cortisol infusion extends the half-life of neutrophils. The role of genomic and central nervous system control through the vagus nerve also is reviewed.Conclusion: Normal volunteers have provided insight into the stress response to infection that is understood only partially.