在死于败血症和多器官衰竭的患者中免疫抑制
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
概括
患有严重败血症的患者表现出显著的免疫抑制,其特征是细胞因子分泌量减少和免疫细胞枯竭. 这表明,免疫增强疗法可能对精选的败血症患者有益.
科学领域:
- 免疫学 免疫学 免疫学
- 关键护理医学 关键护理医学
- 病理生理学 病理生理学
背景情况:
- 严重的败血症最初涉及高炎症,但随后的免疫抑制阶段是有争议的.
- 人类对败血症引起的免疫功能障碍的数据仍然存在矛盾.
研究的目的:
- 调查与败血症相关的先天性和适应性免疫的变化.
- 探索潜在的败血症诱导免疫抑制的潜在机制.
主要方法:
- 分析了40名败血症患者和对照者的死后脏和肺组织.
- 检测包括细胞因子分泌,免疫型和免疫组织化学.
主要成果:
- 与对照组相比,败血症患者的细胞因子分泌显著减少 (TNF,IFN-γ,IL-6,IL-10).
- 在败血症患者中观察到抑制受体的表达增加和抑制细胞的扩张.
- 观察到脏CD4,CD8和HLA-DR细胞的大量耗尽.
结论:
- 死于败血症的患者表现出免疫抑制,由生化和细胞变化证明.
- 针对性免疫增强疗法可能为特定的败血症病例提供治疗策略.
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