先天免疫在机械通气相关性肺损伤发病机制中作用的研究进展

Role of innate immunity in the pathogenesis of ventilation-induced lung injury

对于接受机械通气的患者而言,机械通气在治疗的同时也是一种损伤因素,会引发或加重肺损伤,即机械通气相关性肺损伤(VILI)。VILI的典型特征是机械应力通过通路传导至细胞内,导致无法控制的炎症级联反应,从而引起肺内炎症细胞激活及大量细胞因子、炎症介质释放,其中先天免疫也参与了VILI的发生发展。大量研究表明,VILI时肺组织可通过释放大量损伤相关分子模式(DAMP)来调节炎症反应。模式识别受体(PRR)通过与DAMP结合参与免疫反应激活,释放大量炎症介质,促进VILI发生发展。近期研究表明,抑制DAMP/PRR信号通路可在VILI中发挥保护作用。因此,本文主要阐述在VILI中阻断DAMP/PRR信号通路的潜在作用,为VILI的治疗提供新思路。

For patients receiving mechanical ventilation,mechanical ventilation is also an injury factor at the same time of treatment,which can lead to or aggravate lung injury,that is,ventilator-induced lung injury(VILI).The typical feature of VILI is that the mechanical stress is transmitted to cells through the pathway,leading to uncontrollable inflammatory cascade reaction,which causes the activation of inflammatory cells in the lung and the release of a large number of cytokines and inflammatory mediators.Among them,innate immunity is also involved in the occurrence and development of VILI.A large number of studies have shown that damaged lung tissue in VILI can regulate inflammatory response by releasing a large number of damage associated molecular pattern(DAMP).Pattern recognition receptor(PRR)participates in the activation of immune response by combining with DAMP,and releases a large number of inflammatory mediators to promote the occurrence and development of VILI.Recent studies have shown that inhibition of DAMP/PRR signaling pathway can play a protective role in VILI.Therefore,this article will mainly discuss the potential role of blocking DAMP/PRR signal pathway in VILI,and provide new ideas for the treatment of VILI.