免疫功能紊乱在脓毒症发病中的作用及意义

有关炎症问题的研究在脓毒症领域开展得很早,目前对它的了解无论是在基础理论还是在临床实践方面也都比较深入。传统观念认为,脓毒症是一种失控的持久性炎症反应,是由感染因素诱发的全身炎症反应综合征(SIRS)。基于这种认识,人们应用大量抗炎措施治疗脓毒症,虽然在动物实验中取得了一定的疗效,但在临床应用中

Host immunosuppression in pathogenesis of sepsis and its clinical implication

The excessive inflammatory response accompanied by a dramatic paralysis of cell-mediated immunity following severe trauma, shock and burns appears to be responsible for the increased susceptibility to subsequent sepsis. The mechanism of immunodepression is quite complicated, and it is clearly related to the primary injury or disease and also the treatment. Many studies have been done to elucidate essential processes involved in host innate antimicrobial action activities, including activation of the immune response and also its down-regulation, as well as the mechanisms of pharmacologic immune suppression. Presently, it is recognized that abnormal activation of the innate immune response often leads to macrophage deactivation, loss of antigen presentation capacity, T-cell anergy, and the rapid apoptotic loss of lymphoid tissues, which all contribute to the development of sepsis. Data are accumulating to suggest that restoration of immune function is necessary for the recovery from sepsis and subsequent multiple organ dysfunction syndrome (MODS). A better understanding of the activated innate immunity and its physiological response will help to develop new therapeutical approaches aiming at modulating the immune response in conditions such as sepsis.