脓毒症相关急性肺损伤/急性呼吸窘迫综合征中肺与肺外器官间的串扰

IF 5.5 1区 医学 Q1 CRITICAL CARE MEDICINE
Bingyu Li, Weishan Lin, Ruomeng Hu, Songjie Bai, Yejiao Ruan, Yushi Fan, Shuya Qiao, Xuehuan Wen, Ruishan Liu, Heyu Chen, Wei Cui, Zhijian Cai, Gensheng Zhang
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引用次数: 0

摘要

脓毒症相关急性肺损伤/急性呼吸窘迫综合征(ALI/ARDS)与相当高的发病率和死亡率相关,但目前的治疗效果有限。以往的研究主要集中在肺本身作为一个孤立的器官,而器官串扰在败血症相关的ALI/ARDS发病机制中的作用不容忽视。同时,忽视对不同感染源引起的脓毒症异质性的讨论,可能是以往研究转化为临床疗效的另一个重要障碍。在这篇综述中,我们初步描述了肺和肺外败血症相关的ALI/ARDS在微生物种类、发病机制、宿主反应和临床表现方面的发病差异。此外,综述了系统性器官串扰机制,包括全身性炎症、肺和肠道微生物组的共性和特异性,以及远端器官级联细胞损伤和死亡。随后,从免疫、神经内分泌、代谢等器官角度探讨肺脓毒症及肺外脓毒症相关ALI/ARDS中肺与肺外器官间的串扰。此外,细胞外囊泡作为败血症中器官-肺串扰的潜在参与者和靶点,代表了一个有前途的研究途径。虽然多器官相互作用的复杂性和脓毒症患者的异质性提出了重大挑战,但这些问题有望通过器官芯片平台、3D类器官培养和多组学技术的出现得到解决。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Crosstalk between lung and extrapulmonary organs in sepsis-related acute lung injury/acute respiratory distress syndrome.

Crosstalk between lung and extrapulmonary organs in sepsis-related acute lung injury/acute respiratory distress syndrome.

Crosstalk between lung and extrapulmonary organs in sepsis-related acute lung injury/acute respiratory distress syndrome.

Crosstalk between lung and extrapulmonary organs in sepsis-related acute lung injury/acute respiratory distress syndrome.

Sepsis-related acute lung injury/acute respiratory distress syndrome (ALI/ARDS) is associated with considerable morbidity and mortality, yet the efficacy of current treatments is limited. Previous studies have predominantly focused on the lung itself as an isolated organ, whereas the role of organ crosstalk in the pathogenesis of sepsis-related ALI/ARDS cannot be overlooked. Meanwhile, neglecting the discussion of heterogeneity in sepsis caused by different sources of infection may be another important obstacle to translating previous studies into clinical efficacy. In this review, we initially delineated the distinctions in pathogenesis between pulmonary and extrapulmonary sepsis-related ALI/ARDS in microbial species, pathogenesis, host response, and clinical manifestations. Additionally, systemic organ crosstalk mechanisms are summarized, including the commonality and specificity of systemic inflammation, lung and gut microbiome, as well as cascade cell injury and death in distant organs. Subsequently, organ crosstalk between lung and extrapulmonary in pulmonary sepsis and extrapulmonary sepsis-related ALI/ARDS are discussed by organs, including immunity, neuroendocrine, metabolism, and so forth. Furthermore, extracellular vesicles represent a promising avenue of research as potential players and targets in organ-lung crosstalk in sepsis. While the complexity of multi-organ interactions and the heterogeneity of septic patients present significant challenges, these issues are expected to be addressed by the emergence of organ-on-a-chip platforms, 3D organoid cultures, and multi-omics techniques.

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来源期刊
Annals of Intensive Care
Annals of Intensive Care CRITICAL CARE MEDICINE-
CiteScore
14.20
自引率
3.70%
发文量
107
审稿时长
13 weeks
期刊介绍: Annals of Intensive Care is an online peer-reviewed journal that publishes high-quality review articles and original research papers in the field of intensive care medicine. It targets critical care providers including attending physicians, fellows, residents, nurses, and physiotherapists, who aim to enhance their knowledge and provide optimal care for their patients. The journal's articles are included in various prestigious databases such as CAS, Current contents, DOAJ, Embase, Journal Citation Reports/Science Edition, OCLC, PubMed, PubMed Central, Science Citation Index Expanded, SCOPUS, and Summon by Serial Solutions.
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