脓毒症的免疫治疗进展  

Progress in immunotherapy of sepsis

作　　者：白冰心[1] 吴言为 张路瑶 薛鲁[1] 唐炜 左建平[1,2] 

机构地区：[1]上海中医药大学免疫与病毒实验室,上海201203 [2]中国科学院上海药物研究所免疫药理实验室,上海201203

出　　处：《中国新药与临床杂志》2015年第3期161-166,共6页Chinese Journal of New Drugs and Clinical Remedies

基　　金：国家自然科学基金项目(81322049);"新药创制"重大专项项目(2014ZX09101002)

摘　　要：严重脓毒症和脓毒症休克是临床重症监护室患者的主要死亡原因之一。对于晚期脓毒症患者机体所处免疫应答状态目前有两种不同观点:一种观点认为,患者固有免疫和适应性免疫进入免疫抑制状态,患者主要死于初次感染清除障碍及继发感染;另一种观点认为,晚期患者固有免疫持续激活,患者主要死于炎症造成的器官损伤。临床用药应根据患者不同的发病阶段及病症选择最佳治疗方案。近年来针对脓毒症导致的机体免疫抑制而研发的药物(如抗PD1抗体、人重组IL-7、GM-CSF等)及针对炎症细胞因子MIF、HMGB1和C5a为靶点而研发的制剂,在动物实验及临床试验中均取得了一定的疗效,为脓毒症的靶向治疗带来了新希望。Severe sepsis and septic shock are currently the main cause of death in intensive care unitpatients. There are two competing views on the host immune response in severe sepsis. One side has argued that both the innate and the adaptive immune systems have entered a marked immunosuppressive state. Deaths have been due to an inability of the patients to clear primary infections and the development of secondary infections. Another competing view has claimed that the activation of innate immunity has been persistent in late sepsis. Late deaths have been due to organ injury caused by innate immune-driven inflammation. The correct therapies should be selected in clinical treatment according to the different stages and symptoms of disease onset.Recently, it has been shown that preparation against immune suppression, such as anti-PD1 antibodies, human recombinant IL-7, GM- CSF, and preparation targeting inflammatory cytokines including MIF, HMGB1 and C5a function very well on the animal models of sepsis and clinical trial. These preparations have brought new insight into targeting therapy of sepsis.

关 键 词：脓毒症 免疫耐受 免疫减弱宿主 炎症 细胞因子类 靶向治疗 

分 类 号：R978[医药卫生—药品]