慢加急性肝衰竭的免疫治疗

韩英; 崔丽娜; 郭冠亚

doi:10.3969/j.issn.1001-5256.2017.09.010

慢加急性肝衰竭的免疫治疗

DOI: 10.3969/j.issn.1001-5256.2017.09.010

第四军医大学西京消化病医院

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中图分类号: R575.3
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出版历程
- 收稿日期: 2017-06-21
- 出版日期: 2017-09-20

Immunotherapy for acute-on-chronic liver failure

Xijing Hospital of Digestive Disease, Fourth Military Medical University

摘要

摘要: 炎症反应和免疫功能紊乱在慢加急性肝衰竭的病程进展中发挥关键作用,导致全身炎症反应综合征,过度的炎症及免疫反应,导致感染易感性增加,最终出现多脏器功能衰竭(MODS)。消除肝损伤并纠正免疫紊乱可预防败血症和(或)MODS,改善患者的生存。迄今为止,ACLF的免疫治疗在各大治疗指南中尚未被推荐。然而,作为ACLF重要病理生理改变,并且与发病率、病死率密切相关的关键事件——肝脏局部和全身炎症反应持续激活及免疫细胞功能障碍,又促使我们不得不考虑免疫调节治疗,以阻断和逆转疾病的进展。因此,简述了目前应用于ACLF治疗的具有潜在免疫调节作用的药物,包括传统药物白蛋白、糖皮质激素等使用,粒细胞集落刺激因子、人工肝支持系统及间充质干细胞移植等的应用,并讨论了一些有希望的未来免疫治疗靶点。
- 肝功能衰竭 /
- 多器官功能衰竭 /
- 免疫疗法 /
- 治疗
Abstract: Inflammatory response and immune dysfunction play important roles in the progression of acute-on-chronic liver failure ( ACLF) and may lead to systemic inflammatory response syndrome. Excessive inflammatory and immune response may result in increased susceptibility to infection and finally lead to multiple organ dysfunction syndrome ( MODS) . Elimination of liver injury and correction of immune dysfunction can prevent sepsis and/or MODS and improve patients'survival. Up to now, immunotherapy for ACLF has not been recommended in related guidelines. However, as an important pathophysiological change of ACLF and a key event closely associated with incidence rate and mortality rate, persistent activation of hepatic and systemic inflammatory response and immune cell dysfunction urges us to consider immunoregulatory treatment, in order to block and reverse disease progression. This article introduces potential immunoregulatory drugs for the treatment of ACLF, including albumin, glucocorticoids, granulocyte colony-stimulating factor, artificial liver support system, and mesenchymal stem cell transplantation, and discusses some promising targets for immunotherapy.
- liver failure /
- multiple organ failure /
- immunotherapy /
- therapy

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参考文献(28)

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