免疫反应与炎症损伤在肝衰竭发病机制中的作用

肝衰竭是临床上常见的严重肝病症候群,该病救治难度大,病死率高,属于内科危急重症之一。肝细胞大量死亡、肝细胞死亡程度超过肝再生的能力被认为是肝衰竭发生发展的核心事件,直接损伤和免疫介导的炎症损伤是这一过程的两个主要因素。越来越多的证据表明,宿主免疫反应与炎症级联反应在肝衰竭发病机制中极为重要。综述了免疫调节(先天性和适应性)与炎症损伤(炎症诱导物、感受细胞、炎症介质)在肝衰竭过程中的作用机制,以及免疫反应/免疫细胞与炎症反应/炎症因子的交互作用,以期有助于了解肝衰竭的发病机制,为肝衰竭的诊疗、药物研发提供新思路。

Role of immune response and inflammatory injury in the pathogenesis of liver failure

Liver failure is a syndrome of severe liver diseases commonly seen in clinical practice,and it has a high mortality rate and thus becomes one of the critical diseases in internal medicine.Massive hepatocyte death and the extent of hepatocyte death exceeding the liver’s regenerative capacity are considered the core events in the development and progression of liver failure,and direct injury and immune-mediated inflammatory injury are the two main factors in this process.An increasing number of evidence has shown that host immune response and inflammatory cascade play an important role in the pathogenesis of liver failure.This article reviews the mechanism of action of immunoregulation(congenital and adaptive)and inflammatory injury(inflammation inducers,receptor cells,and inflammatory mediators)in the process of hepatic failure,as well as the interactions between immune response and immune cells and between inflammatory response and inflammatory factors,in order to help understand the pathogenesis of liver failure and provide new ideas for the diagnosis and treatment of liver failure and drug research and development.