代谢重编程——SIRS二次打击的枢纽

Metabolic Reprogramming-Hub of Second Strike of SIRS

全身炎症反应综合征(SIRS)是多种创伤及感染性疾病共同的病理过程。临床上部分严重创伤或感染性休克患者在遭受细菌或内毒素等的“二次打击”后巨噬细胞、中性粒细胞等多种炎症细胞被激活并释放大量炎症因子,这一过程不仅伴有炎症细胞自身代谢的重编程,其代谢产物的变化又可反馈性促进SIRS的发生发展,如参与巨噬细胞分化、炎症细胞激活、信号通路转导。由此可见,代谢重编程及其代谢产物可能通过多种机制反馈性诱发炎症细胞激活,触发炎症的级联反应,形成恶性循环,加重二次打击,是SIRS介导多器官功能障碍综合征的重要机制之一。

Systemic inflammatory response syndrome(SIRS)is a common pathological process of various traumatic and infectious diseases.In some patients with severe trauma or septic shock who have suffered a"secondary strike"by bacteria or endotoxinis,many inflammatory cells,such as macrophages and neutrophils,are activated and release a large number of inflammatory factors,the process is not only accompanied by reprogramming of inflammatory cell metabolism,its metabolites changes can also promote the occurrence and development of SIRS as a feedback effect,such as involvement in macrophage differentiation,inflammatory cell activation,signal pathway transduction,etc.As can be seen,metabolic reprogramming and its metabolites may induce inflammatory cell activation through multiple mechanisms as feedbacks,trigger a cascade of inflammation,form a vicious circle,and cause a secondary strike on SIRS,which is one of the important mechanisms of SIRS-mediated multiple organ dysfunction syndrome.