Sepsis is a common complication of combat injuries and trauma,and is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.It is also one of the significant causes of deat...Sepsis is a common complication of combat injuries and trauma,and is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.It is also one of the significant causes of death and increased health care costs in modern intensive care units.The use of antibiotics,fluid resuscitation,and organ support therapy have limited prognostic impact in patients with sepsis.Although its pathophysiology remains elusive,immunosuppression is now recognized as one of the major causes of septic death.Sepsis-induced immunosuppression is resulted from disruption of immune homeostasis.It is characterized by the release of antiinflammatory cytokines,abnormal death of immune effector cells,hyperproliferation of immune suppressor cells,and expression of immune checkpoints.By targeting immunosuppression,especially with immune checkpoint inhibitors,preclinical studies have demonstrated the reversal of immunocyte dysfunctions and established host resistance.Here,we comprehensively discuss recent findings on the mechanisms,regulation and biomarkers of sepsis-induced immunosuppression and highlight their implications for developing effective strategies to treat patients with septic shock.展开更多
Objective：Acute respiratory distress syndrome （ARDS） is an acute and lethal clinical syndrome that is characterized by the injury of alveolar epithelium, which impairs active fluid transport in the lung, and impede...Objective：Acute respiratory distress syndrome （ARDS） is an acute and lethal clinical syndrome that is characterized by the injury of alveolar epithelium, which impairs active fluid transport in the lung, and impedes the reabsorption of edema fluid from the alveolar space. This review aimed to discuss the role of pro-resolving mediators on the regulation of alveolar fluid clearance （AFC） in ARDS.Data Sources：Articles published up to September 2017 were selected from the PubMed, with the keywords of ＂alveolar fluid clearance＂ or ＂lung edema＂ or ＂acute lung injury＂ or ＂acute respiratory distress syndrome＂ , and ＂specialized pro-resolving mediators＂ or ＂lipoxin＂ or ＂resolvin＂ or ＂protectin＂ or ＂maresin＂ or ＂alveolar epithelial cells＂ or ＂aspirin-triggered lipid mediators＂ or ＂carbon monoxide and heme oxygenase＂ or ＂annexin A1＂ .Study Selection：We included all relevant articles published up to September 2017, with no limitation of study design.Results：Specialized pro-resolving mediators （SPMs）, as the proinflammatory mediators, not only upregulated epithelial sodium channel, Na,K-ATPase, cystic fibrosis transmembrane conductance regulator （CFTR）, and aquaporins levels, but also improved Na,K-ATPase activity to promote AFC in ARDS. In addition to the direct effects on ion channels and pumps of the alveolar epithelium, the SPMs also inhibited the inflammatory cytokine expression and improved the alveolar epithelial cell repair to enhance the AFC in ARDS.Conclusions：The present review discusses a novel mechanism for pulmonary edema fluid reabsorption. SPMs might provide new opportunities to design ＂reabsorption-targeted＂ therapies with high degrees of precision in controlling ALI/ARDS.展开更多
基金supported by the National Natural Science Foundation of China(82222038,82020108021 and 82260372)the Chongqing Special Project for Academicians(cstc2020yszx-jcyjX0004)the Chongqing Outstanding Youth Foundation and Science Foundation for Outstanding Youth of the Army Medical Centre(2019CXJSB004)。
文摘Sepsis is a common complication of combat injuries and trauma,and is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.It is also one of the significant causes of death and increased health care costs in modern intensive care units.The use of antibiotics,fluid resuscitation,and organ support therapy have limited prognostic impact in patients with sepsis.Although its pathophysiology remains elusive,immunosuppression is now recognized as one of the major causes of septic death.Sepsis-induced immunosuppression is resulted from disruption of immune homeostasis.It is characterized by the release of antiinflammatory cytokines,abnormal death of immune effector cells,hyperproliferation of immune suppressor cells,and expression of immune checkpoints.By targeting immunosuppression,especially with immune checkpoint inhibitors,preclinical studies have demonstrated the reversal of immunocyte dysfunctions and established host resistance.Here,we comprehensively discuss recent findings on the mechanisms,regulation and biomarkers of sepsis-induced immunosuppression and highlight their implications for developing effective strategies to treat patients with septic shock.
文摘Objective：Acute respiratory distress syndrome （ARDS） is an acute and lethal clinical syndrome that is characterized by the injury of alveolar epithelium, which impairs active fluid transport in the lung, and impedes the reabsorption of edema fluid from the alveolar space. This review aimed to discuss the role of pro-resolving mediators on the regulation of alveolar fluid clearance （AFC） in ARDS.Data Sources：Articles published up to September 2017 were selected from the PubMed, with the keywords of ＂alveolar fluid clearance＂ or ＂lung edema＂ or ＂acute lung injury＂ or ＂acute respiratory distress syndrome＂ , and ＂specialized pro-resolving mediators＂ or ＂lipoxin＂ or ＂resolvin＂ or ＂protectin＂ or ＂maresin＂ or ＂alveolar epithelial cells＂ or ＂aspirin-triggered lipid mediators＂ or ＂carbon monoxide and heme oxygenase＂ or ＂annexin A1＂ .Study Selection：We included all relevant articles published up to September 2017, with no limitation of study design.Results：Specialized pro-resolving mediators （SPMs）, as the proinflammatory mediators, not only upregulated epithelial sodium channel, Na,K-ATPase, cystic fibrosis transmembrane conductance regulator （CFTR）, and aquaporins levels, but also improved Na,K-ATPase activity to promote AFC in ARDS. In addition to the direct effects on ion channels and pumps of the alveolar epithelium, the SPMs also inhibited the inflammatory cytokine expression and improved the alveolar epithelial cell repair to enhance the AFC in ARDS.Conclusions：The present review discusses a novel mechanism for pulmonary edema fluid reabsorption. SPMs might provide new opportunities to design ＂reabsorption-targeted＂ therapies with high degrees of precision in controlling ALI/ARDS.
