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瘤坏死因子 (TNF) 在败血症中的不同影响:实验研究的元分析

Christian Kassasseya¹, Ligia Iulia Torsin^2,3, Caroline Musset¹

¹Emergency Department, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France.

Critical care (London, England)

|September 3, 2024

概括

瘤亡因子 (TNF) 在败血症中起着可变的作用,在模仿临床条件的模型中观察到适应性效应,而在其他模型中则观察到不适当的效应. 实验模型显著影响TNF在感染期间是否有益或有害.

科学领域:

免疫学免疫学免疫学
病理生理学病理生理学
实验医学是一种实验医学.

背景情况:

关于瘤坏死因子 (TNF) 在败血症和内毒性病的动物模型中的作用,存在相互矛盾的结果.
之前的研究报告了TNF在这些实验环境中的适应性和不适当的影响.
需要进行全面的元分析来协调这些差异,并确定影响因素.

研究的目的:

进行动物研究的元分析,以澄清TNF在败血症和内毒性病中的作用.
为了确定因素,特别是实验协议,解释TNF的效果的相互矛盾的结果.
根据特定的实验条件来确定TNF信号是否适应性或不适当.

主要方法:

按照PRISMA指南进行的系统审查和元分析,注册在PROSPERO.
在PubMed和Embase搜索了关于败血症死亡率和修改TNF信号的动物研究.
使用SYRCLE工具评估偏差风险;根据统计学意义,汇总死亡率和加权风险比率分析数据.

主要成果:

包括175项研究 (760个实验,19899只动物),主要是小鼠和老鼠.
TNF无活化与不适当的TNF分泌有关,而TNF注射显示具有适应性作用.
脂聚糖 (LPS) 模型与不适当的TNF作用有关,而活细菌模型 (例如,CLP,肺炎) 显示了适应性作用,特别是在Listeria monocytogenes和Streptococcus pneumoniae等毒性细菌中.

结论:

在感染中TNF的作用高度依赖于使用的实验模型.
用毒性细菌模拟临床条件的模型证明了TNF的适应性作用.
使用LPS或低致病性细菌的模型,特别是抗生素治疗,与TNF的不适当作用有关.

关键词:

实验研究实验研究.无活化无活化这是一种LPS感染.死亡率死亡率死亡率病原体是一种病原体.败血症这是一种败血症.这就是TNF TNF.

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