PD-1/PD-L1通路在脓毒症晚期免疫抑制作用中的研究进展  

Research Progress of PD-1/PD-L1 Pathway in Immunosuppression in Advanced Sepsis

作　　者：蔡威 范骏[1] CAI Wei;FAN Jun(Department of Emergency,the Second Affiliated Hospital,Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第二附属医院急诊科,南昌330006

出　　处：《南昌大学学报（医学版）》2022年第5期81-84,96,共5页Journal of Nanchang University：Medical Sciences

基　　金：国家自然科学基金(81960347)。

摘　　要：脓毒症是炎症、免疫激活、缺氧等复杂因素相互作用的结果,目前仍缺少针对性治疗方案。文章指出免疫负性调控蛋白程序性细胞死亡受体1(PD-1)/程序性细胞死亡配体1(PD-L1)通路可通过胞内多种机制,如磷酸磷脂酰激酶-3(PI3K)等诱导脓毒症患者T、B淋巴细胞,抗原提呈(DC)细胞,中性粒细胞等免疫细胞的凋亡、耗竭,以此维持机体抗炎和促炎反应的平衡,这种过度的免疫负性调控导致晚期脓毒症患者出现免疫抑制状态,是导致患者死亡的主要原因。提示脓毒症免疫抑制是一个多细胞、多种群、多层次参与的复杂的病理生理过程,PD-1/PD-L1通路在晚期脓毒症免疫抑制发挥着重要作用。抗PD-1抗体在体内和体外实验中已取得阶段性治疗成效,PD-1/PD-L1通路可成为治疗脓毒症的一个新靶标。Sepsis is the result of complex interaction of inflammation,immune activation,hypoxia and other factors.At present,there is a lack of targeted treatment for sepsis.Studies have confirmed that the programmed cell death-1(PD-1)/programmed cell death ligand 1(PD-L1)pathway can maintain the balance of anti-and pro-inflammatory responses through various intracellular mechanisms,such as the induction of T and B lymphocytes by phosphatidyl inositol-3-kinase,and the apoptosis and exhaustion of dendritic cells,neutrophils and other immune cells.However,the excessive negative immunoregulation leads to immunosuppression in patients with advanced sepsis,which is one of the main reasons for death of patients.Sepsis-associated immunosuppression is a complex pathophysiological process involving multiple cells,populations and levels,and PD-1/PD-L1 pathway plays an important role in immunosuppression in advanced sepsis.Anti-PD-1 antibody has achieved phased therapeutic efficacy in the in vivo and in vitro experiments.The PD-1/PD-L1 pathway may become a new target for the treatment of sepsis.

关 键 词：脓毒症 晚期 程序性细胞死亡受体1/程序性细胞死亡配体1 免疫抑制 髓原性抑制细胞 

分 类 号：R459.7[医药卫生—急诊医学]