血小板外泌体在脓毒症免疫麻痹中的研究进展

Research Progress of Platelet Exosomes in Sepsis Induced Immune Paralysis

摘要: 脓毒症是由于宿主在感染时出现免疫反应不足，导致的脏器功能障碍的综合征。脓毒症发病机制尚不明确，包括重负荷感染、免疫功能失调、血管内皮细胞受损等病理生理过程。充分的液体复苏、抗感染、器官功能支持作为脓毒症的非特异性的临床治疗，患者常可幸免于早期感染，但却因脓毒症持续存在或继发感染导致病情恶化(可能与脓毒血症病程中出现的代偿性抗炎反应导致机体处于“免疫麻痹”状态相关)，在脓毒症的新药物研发上，其中恢复免疫反应的药物可能是最有前途的。在抗肿瘤药物领域，外泌体的免疫疗法非常显著。因此，探索外泌体在脓毒症发展过程中的免疫麻痹机制，尝试为后续研发脓毒症新的药物提供研究基础具有现实意义。本文就血小板外泌体在脓毒症免疫麻痹中的研究进展进行综述。

Abstract: Sepsis is a syndrome of organ dysfunction caused by insufficient immune response of the host during infection. The pathogenesis of sepsis is not yet clear, including pathological and physiological processes such as heavy load infection, immune dysfunction, and damage to vascular endothelial cells. Adequate fluid resuscitation, anti infection, and organ function support are non-specific clinical treatments for sepsis. Patients are often spared from early infection, but their condition worsens due to the persistent or secondary infection of sepsis (which may be related to compensatory anti-inflammatory reactions that occur during the course of sepsis, leading to immune paralysis). In the development of new drugs for sepsis, among them, drugs that restore immune response may be the most promising. In the field of anti-tumor drugs, the immunotherapy of extracellular vesicles is very significant. Therefore, exploring the immune paralysis mechanism of extracellular vesicles in the development of sepsis and attempting to provide a research basis for the subsequent development of new drugs for sepsis is of practical significance. This article reviews the research progress of platelet exosomes in sepsis induced immune paralysis.