脓毒症中的细胞凋亡

脓毒症指机体对感染产生的全身性炎症反应的综合征,常发生于外伤、烧伤或免疫力低下时病原体严重感染,重者可发展为感染性休克、DIC和多器官功能衰竭等改变1].脓毒症的发病机制与感染病原体、宿主免疫系统、炎症反应和凝血系统之间复杂的相互作用密切相关,其中全身炎症反应综合征(systemic inflammatory response syndrome,SIRS)、多器官损伤和感染性休克是常见的病理生理过程,但由于具体机制尚不明确,临床治疗效果不佳,死亡率一直居高不下2,3].近年来研究显示细胞凋亡变化是脓毒症重要的病理变化之一4].细胞凋亡(apoptosis)又称程序性细胞死亡,是机体形态发生、组织重塑和免疫反应消退过程中的一种主动性的死亡方式.与细胞坏死不同,凋亡的细胞或凋亡小体可被临近细胞所吞噬而不引起周围组织炎症反应.

Apoptosis in sepsis

Immune cells that undergo increased apoptosis include lymphocytes and macrophages, yet the apoptosis of neutrophils is decreased in sepsis. Increase in apoptosis has also been reported in non-immune cells such as gastrointestinal cells, epithelial cells of lung as well as endothelial cells. The altered apoptotic cell death may contribute to the initiation and aggravation of immune and organ dysfunction in sepsis. Elucidating the changes and mechanism of apoptosis and taking measures to control apoptosis may be an effective strategy for the treatment of sepsis.