共抑制分子在脓毒症免疫功能障碍中作用的研究进展  

Study progress of role of co-suppressor molecules in sepsis immune dysfunction

作　　者：高经华 刘喆滢 刘志锋 Gao Jinghua;Liu Zheying;Liu Zhifeng(The First School of Clinical Medicine,Southern Medical University,Guangzhou 510515,Guangdong,China;Department of Critical Care Medicine,General Hospital of Southern Theatre Command of PLA,Guangzhou 510010,Guangdong,China)

机构地区：[1]南方医科大学第一临床医学院,广州510515 [2]南部战区总医院重症医学科,广州510010

出　　处：《中华危重病急救医学》2020年第1期121-125,共5页Chinese Critical Care Medicine

基　　金：国家自然科学基金(81571940,81741125);军队后勤医学科研项目(CWH17L020,17CXZ008,18CXZ030)。

摘　　要：脓毒症是宿主应对感染时发生危及生命的器官功能障碍的综合征,其病理生理核心是在发病初始,机体为了应对病原微生物入侵而引发剧烈的炎症反应,随后为了平衡免疫状态,机体开始抗炎、发生免疫细胞功能衰竭,最终引发免疫麻痹或免疫抑制。无论是在天然免疫还是在获得性免疫中,免疫细胞表面的共抑制分子,如程序性死亡受体-1(PD-1)、T细胞免疫球蛋白及黏蛋白分子-3(TIM-3)、细胞毒性T淋巴细胞相关抗原-4(CTLA-4)、自然杀伤细胞受体2B4(CD244)、B和T淋巴细胞衰减因子(BTLA)及C型凝集素家族成员NKG2A(CD94),在调节免疫细胞功能低下致免疫抑制方面发挥了重要作用,而阻断这些共抑制分子与其配体之间的相互作用,能显著改善脓毒症动物模型或脓毒症患者的免疫抑制状态。本文主要概括归纳近年来一些共抑制分子在脓毒症免疫功能障碍中作用的热门研究,以期为脓毒症免疫功能监测及治疗靶点提供参考方向。Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection.The pathophysiology core issue is that the body initiates a severe inflammatory reaction in response to the invasion of pathogenic microorganisms at the initial stage of disease.Subsequently,the body begins to fight inflammation in order to balance immunity status and eventually induces the immune paralysis or immunosuppressive state characterized by exhaustion of immune cell.Both in innate immunity and in acquired immunity,some co-suppressor molecules on the surface of immune cells play important roles in immunosuppression,such as,programmed death receptor-1(PD-1),T cell immunoglobulin and mucin-containing protein-3(TIM-3),cytotoxic T lymphocyte associated antigen-4(CTLA-4),natural killer cell receptor 2B4(CD244),B and T lymphocyte attenuator(BTLA)and NKG2A(CD94),et al.Blocking the interaction between these co-suppressor molecules and their ligands can significantly reverse the immunosuppressive state in septic animal models or patients.In order to provide a reference for the monitoring and treatment of sepsis immune dysfunction,this article mainly summarizes the new findings on the role of those co-suppressor molecules in sepsis immune dysfunction in recent years.

关 键 词：脓毒症 共抑制分子 免疫监测 免疫抑制 

分 类 号：R459.7[医药卫生—急诊医学]