国际麻醉学与复苏杂志   2018, Issue (2): 12-12
    
急性系统性炎症介导中枢性炎症机制的研究进展
阚敏慧, 王天龙1()
1.首都医科大学宣武医院麻醉科
Research progress of the mechanisms underlying transition of acute systemic inflammation to central inflammation
 全文:
摘要:

背景 炎症包括系统性炎症和中枢性炎症,在手术、创伤和感染等方面均发挥着重要作用。目前急性系统性炎症发展成中枢性炎症相关机制的临床或基础研究甚少,其机制至今不明。 目的  就急性系统性炎症向中枢性炎症的可能传递机制及物质基础进行综述,从而可能为预防或缓解术后中枢性炎症的发生及改善认知功能障碍提供新的思路。 内容 炎症信号在外周和中枢间的传递可能是联系中枢性炎症与外周炎症的重要途径, 这一机制对于全面认识中枢神经系统疾病的发病机制以及相关疾病的预防和治疗具有重要意义。 趋向 为寻找适宜的抗炎药物或麻醉管理方案奠定理论基础,对于中枢炎症或认知障碍的预防和治疗具有潜在前景。

关键词: 系统性炎症; 中枢性炎症; 脂多糖; 炎症因子; 内皮细胞表层
Abstract:

Background Systemic and central inflammation play important roles in surgery, trauma, and infection. It is still unclear how acute systemic inflammation develops into central inflammation. Objective To review the potential mechanisms and substrates for the transition from acute systemic inflammation to central inflammation in order to provide insights for preventing or alleviating postoperative neuroinflammation and cognitive dysfunction. Content Inflammation in the central nervous system is commonly seen in surgeries in non-nervous systems, septicemia, burn, and injury of organs, and might incur cognitive dysfunctions and neurodegenerative diseases. Inflammation factors and cytokines released during systemic inflammation increase permeability of blood-brain-brarrier (BBB), resulting in infiltration of inflammation factors, cytokines, and immune cells into the brain. The increase of permeability of blood-brain-brarrier is related to the damage of the integrity of endothelia glycocalyx layer following sepsis, inflammation, and dramatic hemodynamic perturbation, as well. Trend To improve integrity of endothelia glycocalyx layer, maintaining normal permeability of blood-brain-brarrier, may be a strategy to prevent the transition of systemic inflammation to central inflammation and neurodegenerative diseases.

Key words: Systemic inflammation; Central inflammation; Lipopolysaccharide; Inflammatory factor; Endothelial surface layer