セプシスや多臓器不全で死亡する患者の免疫抑制
Jonathan S Boomer1, Kathleen To, Kathy C Chang
1Department of Medicine, Washington University School of Medicine, 660 S Euclid, St Louis, MO 63110, USA.
JAMA
|December 22, 2011
まとめ
重度の敗血症の患者は,免疫抑制が著しく低下し,シトカインの分泌が低下し,免疫細胞が枯渇することが特徴です. これは,免疫強化療法が選択されたセプシス患者にとって有益である可能性があることを示唆しています.
科学分野:
- 免疫学 免疫学とは
- クリティカルケア・メディシン
- 病理生理学 病理生理学とは
背景:
- 重度のセプシスは最初は高炎症を含みますが,その後の免疫抑制フェーズについては議論されています.
- セプシス誘発の免疫機能不全に関するヒトのデータは矛盾しています.
研究 の 目的:
- セプシスに関連した先天性および適応性免疫の変化を調査する.
- 潜在的セプシス誘発免疫抑制の原因となるメカニズムを探求する.
主な方法:
- 40人のセプシス患者と対照群の死後のと肺組織を分析した.
- アッセイには,サイトカイン分泌,免疫フェノタイプ化,免疫ヒスト化学が含まれていました.
主要な成果:
- セプシス患者は,対照群と比較して,サイトカイン分泌 (TNF,IFN-γ,IL-6,IL-10) が著しく減少した.
- 阻害受容体の発現の増加と抑制細胞の膨張がセプシス患者で観察されました.
- 臓のCD4,CD8,HLA-DR細胞の大幅な枯渇が認められた.
結論:
- セプシスで死亡する患者は,生化学的および細胞の変化によって証明される免疫抑制を示します.
- 標的型免疫強化療法では,特定のセプシス症例の治療戦略を提供することができる.
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