細胞素風暴

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細胞因子
分类和外部资源
DiseasesDB 34296

細胞因子風暴英语:Cytokine storm),又稱高細胞因子症英语:Hypercytokinemia),一種不適當的免疫反應,因為細胞因子免疫細胞間的正回饋回路而產生。这也被认为是1918年流感大流行[1]、2003年SARS事件[2]2009年H1N1流感大流行[3],以及H5N1高致病性禽流感中病毒致死的原因[4]不过美国疾病控制与预防中心认为这一症状与H1N1之间的没有充分的证据可以展示其关联性。[5]

症狀[编辑]

症狀為高燒、紅腫、腫脹、極度疲倦噁心。在某些情况下可能致命。

成因[编辑]

免疫系统对抗病原体时,细胞因子会引导免疫细胞前往受感染处。同时,細胞因子也会激活这些免疫细胞,被激活的免疫细胞则会产生更多的细胞素。[6]通常来说,人体会检查并控制这个反馈循环。但是在有些情况下,情况会失控,导致一个地方聚集了太多被激活的免疫细胞。目前为止,还没有完全了解这一现象的具体成因,但是有推测认为可能是由于免疫系统对新的、高致病的病原体产生的过激反应。

细胞因子风暴有可能会对身体组织和器官产生严重的损伤,比如当其发生于部,过多的免疫细胞和组织液可能会在肺部积聚,阻塞空气进出,并导致死亡。

治疗[编辑]

尽管有充分的证据显示细胞因子风暴在重症急性感染中的重要地位,但至今在预防及改善临床预后方面收效甚微。目前可用的治疗方案有OX40英语CD134抗体(OX40-Ig,也称CD134英语CD134抗体)[7]血管紧张肽I转化酶抑制剂[8]血管紧张素II受体拮抗剂[9]皮質類固醇[10]吉非羅齊英语Gemfibrozil抗氧化剂[11]腫瘤壞死因子-α抑制剂[12]

参考[编辑]

  1. ^ Michael T. Osterholm. Preparing for the next pandemic. The New England Journal of Medicine. 2005-05-05, 352 (18): 1839–1842 [2019-02-12]. ISSN 1533-4406. PMID 15872196. doi:10.1056/NEJMp058068. 
  2. ^ Kao-Jean Huang, Ih-Jen Su, Michel Theron, Yi-Chun Wu, Shu-Kuan Lai, Ching-Chuan Liu, Huan-Yao Lei. An interferon-gamma-related cytokine storm in SARS patients. Journal of Medical Virology. 2005-2, 75 (2): 185–194 [2019-02-12]. ISSN 0146-6615. PMID 15602737. doi:10.1002/jmv.20255. 
  3. ^ Lacey M McNeil DG Jr. Fighting Deadly Flu, Mexico Shuts Schools. NYTimes.com. 2009-04-24 [2009-04-29]. 
  4. ^ Azizul Haque, Didier Hober, Lloyd H. Kasper. Confronting potential influenza A (H5N1) pandemic with better vaccines. Emerging Infectious Diseases. 2007-10, 13 (10): 1512–1518 [2019-02-12]. ISSN 1080-6059. PMC 2851514. PMID 18258000. doi:10.3201/eid1310.061262. 
  5. ^ Interim Guidance for Clinicians on Identifying and Caring for Patients with Swine-origin Influenza A (H1N1) Virus Infection. Centers for Disease Control and Prevention (CDC). 2009-04-29 [2009-04-29]. 
  6. ^ Murphy, K.; Travers, P.; Walport, M. Signaling Through Immune System Receptors.. Janeway's Immunobiology. 7th. London: Garland. 2007. ISBN 0-8153-4123-7. 
  7. ^ Ian R. Humphreys, Gerhard Walzl, Lorna Edwards, Aaron Rae, Sue Hill, Tracy Hussell. A critical role for OX40 in T cell-mediated immunopathology during lung viral infection. The Journal of Experimental Medicine. 2003-10-20, 198 (8): 1237–1242 [2019-02-12]. ISSN 0022-1007. PMC 2194232. PMID 14568982. doi:10.1084/jem.20030351. 
  8. ^ Gultekin Genctoy, Bulent Altun, Ahmet Alper Kiykim, Mustafa Arici, Yunus Erdem, Meltem Cağlarg, Unal Yasavul, Cetin Turgan, Sali Cağlar. TNF alpha-308 genotype and renin-angiotensin system in hemodialysis patients: an effect on inflammatory cytokine levels?. Artificial Organs. 2005-2, 29 (2): 174–178 [2019-02-12]. ISSN 0160-564X. PMID 15670287. doi:10.1111/j.1525-1594.2005.29029.x. 
  9. ^ Aigul Moldobaeva, Elizabeth M. Wagner. Angiotensin-converting enzyme activity in ovine bronchial vasculature. Journal of Applied Physiology (Bethesda, Md.: 1985). 2003-12, 95 (6): 2278–2284 [2019-02-12]. ISSN 8750-7587. PMID 12897028. doi:10.1152/japplphysiol.00266.2003. 
  10. ^ Drazen, Jeffrey M.; Cecil, Russell L.; Goldman, Lee; Bennett, J. Claude. Cecil Textbook of Medicine 21st. Philadelphia: W.B. Saunders. 2000. ISBN 0-7216-7996-X. 
  11. ^ Alison Budd, Lisa Alleva, Mohammed Alsharifi, Aulikki Koskinen, Victoria Smythe, Arno Müllbacher, Jeff Wood, Ian Clark. Increased survival after gemfibrozil treatment of severe mouse influenza. Antimicrobial Agents and Chemotherapy. 2007-8, 51 (8): 2965–2968 [2019-02-12]. ISSN 0066-4804. PMC 1932503. PMID 17562808. doi:10.1128/AAC.00219-07. 
  12. ^ L. B. S. Gelinck, A. E. van der Bijl, W. E. P. Beyer, L. G. Visser, T. W. J. Huizinga, R. A. van Hogezand, G. F. Rimmelzwaan, F. P. Kroon. The effect of anti-tumour necrosis factor alpha treatment on the antibody response to influenza vaccination. Annals of the Rheumatic Diseases. 2008-5, 67 (5): 713–716 [2019-02-12]. ISSN 1468-2060. PMID 17965123. doi:10.1136/ard.2007.077552.