The immune system's role in sepsis progression, resolution, and long-term outcome.
The immune system's role in sepsis progression, resolution, and long-term outcome.
复制标题
DOI：
10.1111/imr.12499
复制
发表时间：
2016-11
影响因子：
8.7
通讯作者：
Ward PA
中科院分区：
文献类型：
--
作者：
Delano MJ;Ward PA
当感染超过局部组织遏制并诱导一系列失调的生理反应导致器官功能障碍时，就会发生脓毒症。脓毒症患者的一个子集进展为脓毒性休克，定义为严重的循环、细胞和代谢异常，并与更高的死亡率相关。从历史上看，脓毒症诱导的器官功能障碍和致死性归因于初始炎症反应和后期抗炎反应之间的复杂相互作用。随着重症监护医学和目标导向干预措施的进步，早期30天败血症死亡率有所下降，但在从急性事件中“康复”后很长一段时间后才稳步上升。由于如此多的败血症幸存者后来死于持续性，复发性，医院和继发性感染，许多研究人员已将注意力转向长期败血症诱导的细胞免疫功能的改变。脓毒症在临床恢复后的持续时间段内明显改变了先天性和适应性免疫应答，免疫抑制、慢性炎症和细菌的持续存在代表了这种改变。了解到脓毒症相关的免疫细胞缺陷与长期死亡率相关，更多的研究集中在免疫调节治疗改善长期患者结局的潜力上。这些努力的重点是更清楚地定义和有效地逆转与长期脓毒症死亡率相关的持续性免疫细胞功能障碍。
Sepsis occurs when an infection exceeds local tissue containment and induces a series of dysregulated physiologic responses that result in organ dysfunction. A subset of patients with sepsis progress to septic shock, defined by profound circulatory, cellular, and metabolic abnormalities, and associated with a greater mortality. Historically, sepsis-induced organ dysfunction and lethality were attributed to the complex interplay between the initial inflammatory and later anti-inflammatory responses. With advances in intensive care medicine and goal-directed interventions, early 30-day sepsis mortality has diminished, only to steadily escalate long after “recovery” from acute events. Since so many sepsis survivors succumb later to persistent, recurrent, nosocomial and secondary infections, many investigators have turned their attention to the long-term sepsis-induced alterations in cellular immune function. Sepsis clearly alters the innate and adaptive immune responses for sustained periods of time after clinical recovery, with immune suppression, chronic inflammation, and persistence of bacterial representing such alterations. Understanding that sepsis-associated immune cell defects correlate with long-term mortality, more investigations have centered on the potential for immune modulatory therapy to improve long term patient outcomes. These efforts are focused on more clearly defining and effectively reversing the persistent immune cell dysfunction associated with long-term sepsis mortality.
登录
查看更多内容
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.
DOI：
10.1152/ajpregu.00432.2003
发表时间：
2004-03-01
影响因子：
2.8
作者：
Brealey, D;Karyampudi, S;Singer, M
通讯作者：
Singer, M
影响因子：
32.4
作者：
Buckley, Christopher D.;Gilroy, Derek W.;Serhan, Charles N.
通讯作者：
Serhan, Charles N.
影响因子：
3.1
作者：
Bergmann, M;Gornikiewicz, A;Függer, R
通讯作者：
Függer, R
影响因子：
8.8
作者：
Broquet, Alexis;Roquilly, Antoine;Asehnoune, Karim
通讯作者：
Asehnoune, Karim