体外循环中先天性免疫细胞活化标志物表达与重要器官损伤

Relationship between the expression of biomarkers in the activated innate immune cell and vital organs injuries during the cardiopulmonary bypass

尽管体外循环(cardiopulmonary bypass,CPB)技术和材料有了长足进步,但CPB下心脏手术依然是并发症发生率最高的手术之一。全身炎性反应是导致并发症的重要原因,以先天性免疫细胞及血小板被活化并上调炎性细胞因子为主要特点。活化后细胞膜表面多种分子被上调或下调,通过释放胞浆蛋白酶和活性氧,激活胞内多条炎性信号通路而放大组织炎性损伤,最终导致器官功能障碍。因此,这些细胞膜活化标志物的表达不仅是细胞活化的标志,而且在术后重要器官损伤过程中发挥重要作用。鉴定这些特异性活化标志物对于阐明器官损伤相关机制、寻找新的预防和治疗手段具有极其重要的意义。本文对CPB下先天性免疫细胞表面活化标志物的表达变化与重要器官损伤之间的关系进行综述。

Although great progress has been achieved in the techniques and materials of cardiopulmonary bypass(CPB),cardiac surgery under CPB is still one of the surgeries with the highest complication rate.The systemic inflammatory response is an important cause of complications,mainly characterized by activation of innate immune cells and platelets,and up-regulation of inflammatory cytokines.After activation,a variety of molecules on the membrane surface are up-regulated or down-regulated,which can amplify tissue inflammatory damage by releasing cytoplasmic protease and reactive oxygen species,and activate multiple inflammatory signaling pathways in the cell,ultimately leading to organ dysfunction.Therefore,the expression of these cell membrane activation markers is not only a marker of cell activation,but also plays an important role in the process of vital organ injury after surgery.Identification of these specific activation markers is of great significance to elucidate the mechanisms related to organ injury and to find new prevention and treatment methods.This article will review the relationship between these activated biomarkers in the innate immune cells and vital organ injuries under CPB.