The Pathogenesis of Sepsis

被引：459

作者：

Stearns-Kurosawa, Deborah J. ^{[1
]}

Osuchowski, Marcin F. ^{[3
]}

Valentine, Catherine ^{[2
]}

Kurosawa, Shinichiro ^{[1
]}

Remick, Daniel G. ^{[1
]}

机构：

[1] Boston Univ, Sch Med, Dept Pathol & Lab Med, Boston, MA 02218 USA

[2] Boston Univ, Sch Med, Dept Internal Med, Boston, MA 02218 USA

[3] AUVA, Trauma Res Ctr, Ludwig Boltzmann Inst Expt & Clin Traumatol, A-1200 Vienna, Austria

来源：

ANNUAL REVIEW OF PATHOLOGY: MECHANISMS OF DISEASE, VOL 6 | 2011年 / 6卷

关键词：

neutrophils; lymphocytes; costimulatory molecules; coagulation; biomarkers; therapy; SYSTEMIC INFLAMMATORY RESPONSE; FACTOR PATHWAY INHIBITOR; NECROSIS-FACTOR-ALPHA; C-REACTIVE PROTEIN; BRAIN NATRIURETIC PEPTIDE; TISSUE FACTOR; SEPTIC SHOCK; FACTOR-XA; MONOCLONAL-ANTIBODY; NEUTROPHIL APOPTOSIS;

D O I：

10.1146/annurev-pathol-011110-130327

中图分类号：

R36 [病理学];

学科分类号：

100104 ;

摘要：

Sepsis is a serious clinical condition that represents a patient's response to a severe infection and has a very high mortality rate. Normal immune and physiologic responses eradicate pathogens, and the pathophysiology of sepsis is due to the inappropriate regulation of these normal reactions. In an ideal scenario, the first pathogen contact with the inflammatory system should eliminate the microbe and quickly return the host to homeostasis. The septic response may accelerate due to continued activation of neutrophils and macrophages/monocytes. Upregulation of lymphocyte costimulatory molecules and rapid lymphocyte apoptosis, delayed apoptosis of neutrophils, and enhanced necrosis of cells/tissues also contribute to the pathogenesis of sepsis. The coagulation system is closely tied to the inflammatory response, with cross talk between the two systems driving the dysregulated response. Biomarkers may be used to help diagnose patients with sepsis, and they may also help to identify patients who would benefit from immunomodulatory therapies.

引用

页码：19 / 48

页数：30

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