基于肠道菌群产物浅谈脓毒症免疫紊乱

Immune disorders of sepsis based on gut microbiota products

脓毒症已成为入住重症监护室(intensive care unit,ICU)患者死亡的主要原因之一,然而目前对于脓毒症尚无特效性治疗办法。针对脓毒症病理生理的研究发现,免疫紊乱在脓毒症的发病及病情发展中起着重要作用。肠道菌群作为人体内最大的共生体,研究显示其可以通过多种方式影响宿主的免疫状态,但确切机制尚无统一报道。基于肠道菌群在宿主免疫调节中的作用,本文从肠道菌群产物的角度综述了肠道菌群在脓毒症免疫调节中的机制,指出肠道菌群一方面能够调节宿主免疫系统的发育和功能;另一方面,脓毒症诱导的肠道菌群失调也将导致菌群产物的改变,从而丧失对免疫系统的正常调节作用,这可能是促进脓毒症进一步发展的重要原因,而基于肠道菌群的生物疗法,或许有望成为脓毒症常规治疗外的重要补充。

Sepsis has become one of the leading causes of death in ICU(intensive care unit)patients,but there is still no specific treatment for sepsis.In the study of the pathophysiology of sepsis,it is found that immune disorder plays an important role in the pathogenesis and development of sepsis.As the largest symbiont in human body,gut microbiota has been shown to affect the immune state of the host in various ways,but the exact mechanism has not been uniformly reported.Based on the role of gut microbiota in host immune regulation,this paper reviews the mechanism of gut microbiota in immune regulation of sepsis from the perspective of gut microbiota products,pointing out that gut microbiota on the one hand regulates the development and function of the host immune system;On the other hand,the imbalance of gut microbiota induced by sepsis will also lead to the change of microbiota products and the loss of the normal regulatory effect on the immune system,which may promote the further development of sepsis and form a vicious cycle.Biologic therapy based on gut microbiota may be an important addition to conventional treatment of sepsis.