腹膜腔免疫特性与腹腔感染

Immunological characteristics of peritoneal cavity and intra-abdominal infection

腹腔感染仍然是当前具有挑战性的临床问题,虽然可采取感染源控制、抗感染药物等措施,但仍可能因机体炎症免疫反应失衡,合并脓毒性并发症,导致预后不良。最近的研究显示,除巨噬细胞和中性粒细胞等天然免疫细胞外,腹膜腔呈现的区域免疫特性值得关注。其中,大网膜被认为是具有独特免疫功能的内脏脂肪组织,由免疫细胞集聚形成的乳斑执行免疫监视,具有类似淋巴结样的免疫功能,对于腹腔的免疫防御非常重要。存在于乳斑和腹膜腔中B1细胞和2类固有淋巴细胞(ILC2)等,虽属于淋巴谱系,但因其快速的响应能力和具备获得性免疫功能的特点,在腹腔感染中,特别是病程早期,可能发挥重要作用。因此,关注腹膜腔区域免疫特性.阐释围绕乳斑及其组成的B1细胞和ILC2等在腹腔感染过程中的变化、作用和调控机制.以探索阻断感染由局部向全身性播散的针对性免疫调控靶点,可能是破解严重腹腔感染这一临床难题、改善预后的关键。

Despite the evolution of aggressive surgical techniques,extensive methods of supportive care and a vast array of anti-microbial options,intra-abdominal infection (IAI)is still a challenging clinical issue.Especially,when progressed IAI with septic complications because of unbalanced immune responses,the prognosis will deteriorated significantly.Recent studies indicate that besides the natural immunological cells,including macrophages and neutrophils, local immunological characteristics of peritoneal cavity should be studied with great attention.Among them,the omentum is considered to be a visceral adipose tissue with unique immune function.The milky spots(MSs)formed by the accumulation of immune cells performs immune surveillance and has a lymph node-like immune function,which is very important for the immune defense of the abdominal cavity.B1 cells and two types of intrinsic lymphocytes (ILC2)in the peritoneal cavity, although belonging to the lymphatic lineage,may play an important role in abdominal infections,especially in the early stages of the disease,due to their rapid responsiveness and acquired immune function.Therefore,paying attention to the immunological characteristics of the peritoneal cavity,and elucidating the changes,functions and regulatory mechanisms of B1 cells and ILC2 around the MSs and their components in the process of IAI,in order to explore the immunomodulation targets of blocking the infection from local to systemic dissemination,may be the key to solving the clinical problem of severe IAI and improving prognosis.