程序性死亡受体-1信号通路在脓毒症中作用的研究进展

Progress in programmed death-1 signaling pathway in sepsis

脓毒症包括高度多样化和动态混合的全身炎症反应综合征(SIRS)及代偿性抗炎反应综合征(CARS)。过去人们开发的阻断早期炎症反应的药物在扭转脓毒症的发展方面收效甚微,最新的研究显示,患者的病死率和预后与脓毒症的免疫抑制阶段及共抑制分子的过度表达有明显关联。程序性死亡受体-1(PD-1)是近年来备受关注的一种共抑制分子,可以调控多种免疫细胞的功能,参与固有免疫和获得性免疫,对脓毒症患者的风险分层及预后预测有重要价值,未来可作为脓毒症免疫调节的干预靶点之一。本文对PD-1信号通路在免疫抑制中的作用及其对患者预后的影响进行综述,为脓毒症的治疗提供新的方向。

Sepsis includes a highly diverse and dynamic mixture of systemic inflammatory response syndrome(SIRS)and compensatory anti-inflammatory response syndrome(CARS).In the past,drugs produced to block the early inflammatory response had little effect on reversing the development of sepsis.Recent studies have shown that the mortality and prognosis of patients are significantly correlated with the immunosuppression of sepsis and the overexpression of co-inhibitory molecules.Programmed death-1(PD-1)is a recently focused co-inhibitory molecule,which can regulate the functions of a variety of immune cells and participate in innate immunity and acquired immunity.It has important value in risk stratification and prognosis prediction of patients with sepsis,and can be used as one of the intervention targets for immune regulation in sepsis in the future.The role of PD-1 signaling pathway in immunosuppression and its effect on patients'prognosis is reviewed in this article,providing new directions for the treatment of sepsis.