Sepsis: Current Dogma and New Perspectives

被引:499
作者
Deutschman, Clifford S. [1 ,2 ]
Tracey, Kevin J. [3 ]
机构
[1] Univ Penn, Perelman Sch Med, Dept Anesthesiol, Philadelphia, PA 19104 USA
[2] Univ Penn, Perelman Sch Med, Crit Care & Surg & Sepsis Res Program, Philadelphia, PA 19104 USA
[3] Feinstein Inst Med Res, Manhasset, NY 11030 USA
关键词
HEART-RATE-VARIABILITY; GUT BARRIER DYSFUNCTION; TOLL-LIKE RECEPTORS; GATED CA2+ CURRENT; NLRP3; INFLAMMASOME; T-CELLS; MITOCHONDRIAL DYSFUNCTION; PROLONGED LYMPHOPENIA; COGNITIVE IMPAIRMENT; CARDIAC-FUNCTION;
D O I
10.1016/j.immuni.2014.04.001
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Sepsis, a clinical syndrome occurring in patients following infection or injury, is a leading cause of morbidity andmortality worldwide. Current immunological mechanisms do not explain the basis of cellular dysfunction and organ failure, the ultimate cause of death. Here we review current dogma and argue that it is time to delineate novel immunometabolic and neurophysiological mechanisms underlying the altered cellular bioenergetics and failure of epithelial and endothelial barriers that produce organ dysfunction and death. These mechanisms might hold the key to future therapeutic strategies.
引用
收藏
页码:464 / 476
页数:13
相关论文
共 111 条
[1]   Clinical review: A review and analysis of heart rate variability and the diagnosis and prognosis of infection [J].
Ahmad, Saif ;
Tejuja, Anjali ;
Newman, Kimberley D. ;
Zarychanski, Ryan ;
Seely, Andrew J. E. .
CRITICAL CARE, 2009, 13 (06)
[2]  
Andersson Ulf, 2012, Cerebrum, V2012, P3
[3]   Neural reflexes in inflammation and immunity [J].
Andersson, Ulf ;
Tracey, Kevin J. .
JOURNAL OF EXPERIMENTAL MEDICINE, 2012, 209 (06) :1057-1068
[4]   Reflex Principles of Immunological Homeostasis [J].
Andersson, Ulf ;
Tracey, Kevin J. .
ANNUAL REVIEW OF IMMUNOLOGY, VOL 30, 2012, 30 :313-335
[5]   HMGB1 Is a Therapeutic Target for Sterile Inflammation and Infection [J].
Andersson, Ulf ;
Tracey, Kevin J. .
ANNUAL REVIEW OF IMMUNOLOGY, VOL 29, 2011, 29 :139-162
[6]   Circulating high-mobility group box 1 (HMGB1) concentrations are elevated in both uncomplicated pneumonia and pneumonia with severe sepsis [J].
Angus, Derek C. ;
Yang, LiHong ;
Kong, Lan ;
Kellum, John A. ;
Delude, Russell L. ;
Tracey, Kevin J. ;
Weissfeld, Lisa .
CRITICAL CARE MEDICINE, 2007, 35 (04) :1061-1067
[7]   Severe Sepsis and Septic Shock [J].
Calis, Job ;
van Woensel, Job ;
Lemson, Joris .
NEW ENGLAND JOURNAL OF MEDICINE, 2013, 369 (21) :2062-2062
[8]  
Antoine DJ., 2014, Mol Med
[9]   Regional Neural Activation Defines a Gateway for Autoreactive T Cells to Cross the Blood-Brain Barrier [J].
Arima, Yasunobu ;
Harada, Masaya ;
Kamimura, Daisuke ;
Park, Jin-Haeng ;
Kawano, Fuminori ;
Yull, Fiona E. ;
Kawamoto, Tadafumi ;
Iwakura, Yoichiro ;
Betz, Ulrich A. K. ;
Marquez, Gabriel ;
Blackwell, Timothy S. ;
Ohira, Yoshinobu ;
Hirano, Toshio ;
Murakami, Masaaki .
CELL, 2012, 148 (03) :447-457
[10]   Heart rate variability in emergency department patients with sepsis [J].
Barnaby, D ;
Ferrick, K ;
Kaplan, DT ;
Shah, S ;
Bijur, P ;
Gallagher, EJ .
ACADEMIC EMERGENCY MEDICINE, 2002, 9 (07) :661-670