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相对上腺功能不足是儿科败血症的危险因素:一项概念验证研究

Dan Hao¹, Ling Guo², Qian Wang²

¹Department of Pharmacology and Nutritional Sciences.

The Journal of infectious diseases

|August 26, 2023

概括

患有相对上腺功能不足 (RAI) 的儿科败血症患者面临更高的死亡率. 葡萄糖皮质激素治疗有效地拯救了这些小鼠,这表明基于RAI状态的个性化治疗.

科学领域:

儿科重症监护儿科重症监护
内分泌学在内分泌学.
免疫学免疫学免疫学

背景情况:

由于证据薄弱,针对儿科败血症的葡萄糖皮质体 (GC) 治疗建议发生了转变.
相对上腺功能缺陷 (RAI) 影响了大约32.8%的儿科败血症患者.
在指导儿科败血症GC治疗中的RAI状态的作用仍然存在争议.

研究的目的:

使用SF1CreSRBIfl/fl小鼠建立第一个儿科RAI小鼠模型.
为了调查RAI在儿科败血症的发病原因.
评估GC治疗在儿科RAI败血症中的疗效.

主要方法:

使用了一种21天的SF1CreSRBIfl/fl小鼠模型用于儿科RAI.
诱导性败血症使用头绑定和穿孔 (CLP) 和头泥 (CS) 模型.
进行RNA测序以分析炎症反应和转录途径.

主要成果:

在RAI小鼠中,在败血症期间的死亡率显著提高.
RAI小鼠表现出持续的炎症反应.
GC疗法有效地拯救了RAI小鼠,并减轻了败血症引起的死亡率.
在RAI小鼠中,RNA测序发现AP-1和NF-κB通路的失调,导致持续性炎症.

结论:

这项研究支持以RAI状态为指导的儿科败血症GC治疗的精准医学策略.
RAI是影响败血症结果和GC治疗反应的关键因素.
这种儿科RAI小鼠模型为未来对败血症发病和治疗的研究提供了宝贵的平台.

关键词:

葡萄糖皮质类药物治疗这是一种可诱导的葡萄糖皮质激素.儿科的败血症相对上腺功能不全的情况.拾尸体受体BI BI 的使用.

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