促炎细胞因子在脓毒症中作用的研究进展

Research advance on the role of pro-inflammatory cytokines in sepsis

脓毒症是一种由感染引发的一系列病理生理异常,也是全世界感染患者致死致残的重要因素之一,因此一直是医学界关注的焦点。细胞因子是一类由细胞分泌的具有生物活性的小分子蛋白物质,参与脓毒症的免疫和炎症调节。许多研究者使用细胞因子靶向治疗脓毒症取得了有益的效果,细胞因子水平也被认为与脓毒症的发生发展和严重程度有关,是脓毒症可靠的生物标志物。本文重点讨论促炎细胞因子,包括β-干扰素(IFN-β)及白细胞介素(IL-1β、IL-3、IL-6、IL-7)。IFN-β和IL-1β在脓毒症的治疗中均具有双面性,即早期小剂量干预可以通过恢复免疫细胞的功能减轻脓毒症,起到保护作用,但同时也与脓毒症严重炎症反应的发生有关,晚期可增加脓毒症患者的病死率;IL-3和IL-6更多是增强"炎症因子风暴",加重损伤;而IL-7主要参与免疫调节,促进淋巴细胞活化,对脓毒症具有一定保护作用。

Sepsis,a series of pathophysiological abnormalities caused by infection,is also one of the most important factors of death and disability in infected patients all over the world,so it has always been the focus of the medical community.Cytokines are small molecule proteins secreted by cells with biological activity,involved in the immune and inflammatory regulation of sepsis.Many studies using cytokine targeting to treat sepsis have achieved beneficial effects,and the level of cytokines is also believed to be related to the development,severity of sepsis,so they are reliable biomarkers of sepsis.Among them,pro-inflammatory cytokines such as interferon-β(IFN-β)and interleukins(IL-1β,IL-3,IL-6,and IL-7)are the focus of the discussion in this review.IFN-βand IL-1βare double-sided in the treatment of sepsis,namely early low-dose treatment can reduce sepsis by restoring the function of immune cells and play a protective effect,but they are also related to severe inflammatory response of sepsis and can aggravate the mortality of sepsis patients.IL-3 and IL-6 focus more on enhancing inflammatory factors and play a damage role.IL-7 mainly participates in immune regulation,promoting lymphocyte activation and protecting sepsis.