切换至 "中华医学电子期刊资源库"

中华老年病研究电子杂志 ›› 2019, Vol. 06 ›› Issue (04) : 40 -44. doi: 10.3877/cma.j.issn.2095-8757.2019.04.009

所属专题: 文献

综述

老年重症肺炎患者的免疫功能状态及个体化治疗研究进展
孔苗苗1, 杨娟1, 朱慕云1,()   
  1. 1. 225001 扬州大学临床医学院
  • 收稿日期:2019-07-06 出版日期:2019-11-28
  • 通信作者: 朱慕云

Research progress on immune function status and individualized treatment of elder patients with severe pneumonia

Miaomiao Kong1, Juan Yang1, Muyun Zhu1,()   

  1. 1. Yangzhou University Medical College, 225001 Yangzhou, China
  • Received:2019-07-06 Published:2019-11-28
  • Corresponding author: Muyun Zhu
  • About author:
    Corresponding author: Zhu Muyun, Email:
引用本文:

孔苗苗, 杨娟, 朱慕云. 老年重症肺炎患者的免疫功能状态及个体化治疗研究进展[J/OL]. 中华老年病研究电子杂志, 2019, 06(04): 40-44.

Miaomiao Kong, Juan Yang, Muyun Zhu. Research progress on immune function status and individualized treatment of elder patients with severe pneumonia[J/OL]. Chinese Journal of Geriatrics Research(Electronic Edition), 2019, 06(04): 40-44.

近年来,老年患者耐药菌感染逐渐增多,在其罹患重症肺炎时,单纯注重抗感染药物的更换可能已不足以改善疾病的转归及预后。研究发现,老年重症肺炎时,机体易发生免疫失衡并进展为免疫抑制,是导致老年患者死亡的重要因素之一。因此,实时监测老年重症肺炎患者的免疫功能指标以及生物标志物的改变,动态观察其免疫功能状态与肺部感染发生、发展的联系,在此基础上给予有效的个体化干预措施,对老年重症肺炎的治疗及疾病转归具有重大的临床意义。

In recent years, the infection of drug-resistant bacteria in elder patients is gradually increasing. When they suffer from severe pneumonia, simply replacing anti-infective drugs may not be enough to improve the outcome and prognosis of the disease. Many studies have found that in the elderly with severe pneumonia, the body is prone to immune imbalance and progresses to immunosuppression, which is one of the important factors leading to the death of elder patients. Therefore, monitoring the changes of immune function indicators and biomarker in real time and observing the relationship between immune function status and the development of severe pulmonary infection dynamically, and giving effective individualized interventions based on these have great clinical significance in the treatment and prognosis of severe pneumonia in the elderly.

[12]
Yu ZX, Ji MS, Yan J, et al. The ratio of Th17/Treg cells as a risk indicator in early acute respiratory distress syndrome[J].Crit Care, 2015, 19: 82.
[13]
陈坤,周秋香,单红卫,等.CD4+CD25+调节性T细胞在脓毒症预后评价中的应用[J].中华急诊医学杂志,2015,24(1):72-76
[14]
Zhao GJ, Li D, Zhao Q, et al. Incidence, risk factors and impact on outcomes of secondary infection in patients with septic shock: an 8-year retrospective study[J]. Sci Rep, 2016, 6:38361.
[15]
Sun N, Wei X, Wang J, et al. Caveolin-1 promotes the imbalance of Th17/Treg in patients with chronic obstructive pulmonary disease[J]. Inflammation, 2016, 39(6):2008-2015.
[16]
吴铁军,张丽娜,亢翠翠.Treg/Th17失衡在脓毒症发病机制中的作用[J].中国病理生理杂志,2011,27(12):2411-2413.
[17]
Liu Q, Zheng H, Chen X, et al. Human mesenchymal stromal cells enhance the immunomodulatory function of CD8+CD28-regulatory T cells[J].Cell Mol Immunol, 2015, 12(6):708-718.
[18]
麦惠强,许进,蓝先旗,等.多发伤患者CD8+CD28-T细胞含量变化及其临床意义[J].南方医科大学学报,2016,36(4):544-547.
[19]
Chinai JM, Janakiram M, Chen F, et al. New immunotherapies targeting the PD-1 pathway[J]. Trends Pharmacol Sci, 2015, 36(9):587-595.
[20]
袁洁铭,李理,袁伟锋,等.老年人T淋巴细胞PD-1高表达在炎症状态下对其功能的影响[J].免疫学杂志,2017,33(6):519-524.
[21]
Kahn JM, Le T, Angus DC, et al. The epidemiology of chronic critical illness in The United States[J]. Crit Care Med, 2015, 43(2):282-287.
[22]
Baertling F, Meissner T, Tmeger A, et al. Granulocyte colony stimulating factor for treatment of neutmpenia-associated infection in Pearson syndrome[J]. Klin Padiatr, 2014, 226(3):190-191.
[23]
Bo L, Wang F, Zhu J, et al. Granulocyte-colony stimulating factor (G-CSF) and granulocyte-macrophage colony stimulaTing factor (GM-CSF) for sepsis: a meta-analysis[J]. Crit Care, 2011, 15(1):R58.
[24]
Mayer CT, Ghorbani P, Nandan A, et al. Selective and efficient generation of functional Batf3-dependent CD103+dendritic cells from mouse bone marrow[J]. Blood, 2014, 124(20):3081.
[25]
Xu Q, Zhu YF, Wang HC, et al. Enhanced efficacy of DNA vaccination against botulinum neurotoxin serotype A by co-administration of plasmids encoding DC-sTimulaTing FlT3L and MIP-3α cytokines[J].Biologicals, 2016, 44(5):441-447.
[26]
Pica F, ChimenTi MS, Gaziano R, et al. Serum thymosin alpha 1 levels in patients with chronic inflammatory autoimmune diseases[J]. Clin Experiment Immunol, 2016, 186(1):39-45.
[27]
Garaci E, Pica F, Matteucci C, et a1. Historical review on thymosin alphal in oncology: preclinical and clinical experiences[J]. Expert Opin Biol Ther, 2015, 15 Suppl 1:S31-S39.
[28]
Yang X, Qian F, He HY, et al. Effect of thymosin alpha-1 on subpopulations of Th1, Th2, Th17, and regulatory T cells (Tregs) in vitro[J]. Braz J Med Biol Res, 2012, 45(1):25-32.
[29]
Patera AC, Drewry AM, Chang K, et al. Frontline science: defects in immune function in patients with sepsis are associated with PD-1 or PD-L1 expression and can be restored by antibodies targeting PD-1 or PD-L1[J]. J Leukoc Biol, 2016, 100(6):1239-1254.
[30]
Zhang Y, Zhou Y, Lou J, et al. PD-L1 blockade improves survival in experimental sepsis by inhibiting lymphocyte apoptosis and reversing monocyte dysfunction[J]. Crit Care, 2010, 14(6):R220.
[31]
Shindo Y, Fuchs AG, Davis CG, et al. Interleukin 7 immunotherapy improves host immunity and survival in a two-hit model of pseudomonas aeruginosa pneumonia[J]. J Leukoc Biol, 2017, 101(2): 543-554.
[32]
Demaret J, et al. STAT5 phosphorylation in T cell subsets from septic patients in response to recombinant human interleukin-7: a pilot study[J]. J Leukoc Biol, 2015, 97(4):791-796.
[33]
Shindo Y, McDonough JS, Chang KC, et al. Anti-PD-L1 peptide improves survival in sepsis[J]. J Surg Res, 2017, 208:33-39.
[34]
Francois B, JeanneT R, Daix T, et al. Interleukin-7 restores lymphocytes in septic shock: the IRIS-7 randomized clinical trial[J]. JCI Insight, 2018, 3(5). doi: 10.1172/jci.insight.98960.
[35]
高铭鑫,李海涛,张帆,等.肺灌注抗肿瘤坏死因子抗体对体外循环肺超微结构的影响[J].中华胸心血管外科杂志,2016,30(1):33-37.
[1]
中国医师协会急诊医师分会.中国急诊重症肺炎临床实践专家共识[J/CD].中国急救医学,2016,36(2):97-107.
[2]
Gentile LF, Cuenca AG, Efron PA, et al. Persistent inflammation and immunosuppression: a common syndrome and new horizon for surgical intensive care [J]. J Trauma Acute Care Surg, 2012, 72(6):1491-1501.
[3]
Su HY, Mo ZX, Chen Z, et al. Severe disease of immune imbalance in ICU: persistent flammation immunosuppression catabolism syndrome[J]. Chin Crit Care Med, 2017, 29 (8):760-764.
[4]
Wang JF, Li JB, Zhao YJ, et al. Up-regulation of programmed cell death 1 ligand 1 on neutrophils may be involved in sepsis-induced immunosuppression: an animal study and a prospective case-control study[J]. Anesthesiology, 2015, 122(4):852-863.
[5]
Gotts JE, Matthay MA. Sepsis: pathophysiology and clinical management[J]. BMJ, 2016, 353:i1585.
[6]
Lee J, Tam H, Adler L, et al. The MHC classⅡantigenpresentation pathway in human monocytes differs by subset and is regulated by cytokines[J]. PloS one, 2017, 12(8):e0183594.
[7]
魏莉,白洁,王丽,等.免疫治疗对重症肺炎患者免疫功能指标的影响研究[J].中华医院感染学杂志,2014,24(12):2871-2873.
[8]
Grailer JJ, Kalbitz M, Zetoune FS, et al. Persistent neutrophil dysfunction and suppression of acute lung injury in mice following cecal ligation and puncture sepsis[J].J Innate Immun, 2014, 6(5):695-705.
[9]
刘军.危重病免疫功能监测研究进展[J].中华重症医学电子杂志(网络版),2019,5(1):56-63.
[10]
程静,姚晔,谢丛华.放射性肺损伤与Th1/Th2免疫失衡研究进展[J].中华放射肿瘤学杂志,2017,26(6):706-710.
[11]
解立新,肖坤.免疫失衡是重症感染的核心问题之一[J].中华结核和呼吸杂志,2018,4(9):675-677.
[1] 梁孟杰, 朱欢欢, 王行舟, 江航, 艾世超, 孙锋, 宋鹏, 王萌, 刘颂, 夏雪峰, 杜峻峰, 傅双, 陆晓峰, 沈晓菲, 管文贤. 联合免疫治疗的胃癌转化治疗患者预后及术后并发症分析[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 619-623.
[2] 林逸, 钟文龙, 李锴文, 何旺, 林天歆. 广东省医学会泌尿外科疑难病例多学科会诊(第15期)——转移性膀胱癌的综合治疗[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(06): 648-652.
[3] 吴伟宙, 王琼仁, 詹雄宇, 郑明星, 李亚县. 广东省医学会泌尿外科疑难病例多学科会诊(第16期)——左肾肉瘤样癌[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(05): 525-529.
[4] 李勇, 彭天明, 王倩倩, 陈育纯, 蒲小勇, 刘久敏. 基于失巢凋亡相关基因的膀胱癌预后模型构建及分析[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(04): 331-339.
[5] 李飞, 郑灶松, 吴芃, 谭万龙. 广东省医学会泌尿外科疑难病例多学科会诊(第16期)——延胡索酸水合酶缺陷型晚期肾细胞癌[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(04): 410-414.
[6] 陈旭, 牛凯, 孙建国. 放疗联合免疫治疗对驱动基因阴性NSCLC的困惑分析及应对策略[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(03): 341-348.
[7] 中华医学会器官移植学分会. 肝移植术后缺血性胆道病变诊断与治疗中国实践指南[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 739-748.
[8] 陈伟杰, 何小东. 胆囊癌免疫靶向治疗进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 763-768.
[9] 魏志鸿, 刘建勇, 吴小雅, 杨芳, 吕立志, 江艺, 蔡秋程. 肝移植术后急性移植物抗宿主病的诊治(附四例报告)[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 846-851.
[10] 魏妙艳, 徐近. 合并远处转移胰腺癌系统性治疗的梳理和展望[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 644-650.
[11] 张英信, 林婷, 张剑文. 构建靶向HLA-A2且表达PD-L1的CAR-Treg细胞及验证其对CD4+T细胞抑制作用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 719-728.
[12] 王龙, 武帅, 王炳智, 郑波, 李文斌, 邹霜梅. 结直肠印戒细胞癌的临床病理特征研究[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(03): 229-235.
[13] 苏生林, 马金兰, 于弘明, 杨晓军. 单细胞测序技术在脓毒症免疫研究中的应用进展[J/OL]. 中华重症医学电子杂志, 2024, 10(03): 279-286.
[14] 王昌前, 林婷婷, 宁雨露, 王颖杰, 谭文勇. 光免疫治疗在肿瘤领域的临床应用新进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 575-583.
[15] 叶禾清, 李杰, 张玉元, 胡炉淇, 吴白露, 李鑫, 叶书文, 李一帆, 高玥, 詹鹏超, 吕培杰, 李臻. 载药微球化疗栓塞联合多纳非尼及PD-1治疗中晚期大肝癌的疗效分析[J/OL]. 中华介入放射学电子杂志, 2024, 12(03): 212-216.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?