Advances in cellular immunomodulatory therapy in patients with sepsis and immune compromized / 中华急诊医学杂志

ABSTRACT

Sepsis is one of the most common causes of mortality in the intensive care units (ICUs) with high mortality rates which may be related to the lack of thoroughly understanding of the specific pathophysiological mechanisms.Improved treatment protocols have resulted in most patients got out of the initial hyperinflammatory phase and entered into a protracted immune suppressed phase.Deaths in this immunosuppressive phase are typically due to failure to control the primary infection or the secondary nosocomial infections often with opportunistic pathogens.As the complexity in multiple systems and varied mechanisms involved in the development of disease,the disorder of immune system and inflammation reaction may be one of the main mechanisms,which were mainly characterized by inflammation cytokines storm and immune dysfunction.The mechanism in the later course of disease may include apoptosis and depletion of immune cells,increased suppression of T regulatory cell and increased myeloid-derived suppressor cell,and cellular exhaustion.In this review we focus on the pathophysiologic mechanism of sepsis with immune compromized,monitoring the immune response,the cellular immunoadjuvant therapy,and improving the recognition of sepsis immunosuppression.