Células y sepsis: un análisis integrado clínico biológico
Palabras clave:
sepsis, neutrófilos, linfocitos, inflamación, células endoteliales, permeabilidad capilar, citocinas
Resumen
La investigación sobre la dinámica celular en la sepsis ha revelado alteraciones clave que comprometen tanto la respuesta inmune como la fisiología de los órganos. Esta revisión destaca la importancia de considerar la hiperinflamación persistente, impulsada por la citoquinemia, así como la fatiga del sistema inmunológico, que pueden llevar a una inflamación crónica y a una respuesta inmune debilitada. Además, la disfunción cardíaca y adrenal agrava la descompensación del paciente, contribuyendo a la aparición de hipotensión y choque séptico. Esto subraya la necesidad urgente de adoptar un enfoque integral en el tratamiento de las complicaciones asociadas. En este contexto, la revisión se centrará en los mecanismos subyacentes que vinculan la sepsis con la disfunción inmune, analizando cómo la reprogramación celular y la activación de diversas vías inflamatorias impactan los resultados clínicos.
Citas
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7. Nobs SP, Kopf M. Tissue-resident macrophages: guardians of organ homeostasis. Trends Immunol. 2021; 42(6):495-507. doi: 10.1016/j.it.2021.04.007
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9. Aschenbrenner AC, Schultze JL. New "programmers" in tissue macrophage activation. Pflugers Arch. 2017;469(3-4):375-83. doi: 10.1007/s00424-017-1943-9
10. Chen S, Yang J, Wei Y, Wei X. Epigenetic regulation of macrophages: from homeostasis maintenance to host defense. Cell Mol Immunol [Internet]. 2020 [cited 2023 Dec 18]; 17: 36–49. Available from: https://www.nature.com/articles/s41423-019-0315-0. doi: https://doi.org/10.1038/s41423-019-0315-0
11. Sica A, Invernizzi P, Mantovani A. Macrophage plasticity and polarization in liver homeostasis and pathology. Hepatology. 2014;59(5):2034-42. doi: 10.1002/hep.26754
12. de Pablo R, Monserrat J, Prieto A, Alvarez-Mon M. Role of circulating lymphocytes in patients with sepsis. Biomed Res Int [Internet]. 2014 [cited 2023 Dec 18]; 2014:671087. Available from: https://pubmed.ncbi.nlm.nih.gov/25302303/. doi: 10.1155/2014/671087
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16. Lv Y, Kim K, Sheng Y, Cho J, Qian Z, Zhao YY, et al. YAP Controls endothelial activation and vascular inflammation through TRAF6. Circ Res [Internet]. 2018 [cited 2023 Dec 18];123(1):43-56. Available from: https://pubmed.ncbi.nlm.nih.gov/29794022/. doi: 10.1161/CIRCRESAHA.118.313143
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18. Ajoolabady A, Pratico D, Ren J. Endothelial dysfunction: mechanisms and contribution to diseases. Acta Pharmacol Sin. 2024; 45:2023-31. doi: https://doi.org/10.1038/s41401-024-01295-8
19. Tsantes AG, Parastatidou S, Tsantes EA, Bonova E, Tsante KA, Mantzios PG, et al. Sepsis-Induced coagulopathy: An update on pathophysiology, biomarkers, and current guidelines. Life (Basel) [Internet]. 2023 [cited 2024 Jan 14];13(2):350. Available from: https://pubmed.ncbi.nlm.nih.gov/36836706/. doi: 10.3390/life13020350
20. Nakamori Y, Park EJ, Shimaoka M. Immune deregulation in sepsis and septic shock: Reversing immune paralysis by targeting PD-1/PD-L1 pathway. Front Immunol [Internet]. 2021 [cited 2024 Jan 14]; 11:624279. Available from: https://pubmed.ncbi.nlm.nih.gov/33679715/. doi: 10.3389/fimmu.2020.624279
21. Cao M, Wang G, Xie J. Immune dysregulation in sepsis: experiences, lessons and perspectives. Cell Death Discov [Internet]. 2023 [cited 2024 Jan 14]; 9(1): 465. Available from: https://pubmed.ncbi.nlm.nih.gov/38114466/. doi: 10.1038/s41420-023-01766-7
22. Neuenfeldt FS, Weigand MA, Fischer D. Coagulopathies in intensive care medicine: Balancing act between thrombosis and bleeding. J Clin Med [Internet]. 2021 [cited 2024 Jan 14];10(22):5369. Available from: https://pubmed.ncbi.nlm.nih.gov/34830667/. doi: 10.3390/jcm10225369
23. Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet [Internet]. 2020 [cited 2024 Jan 14];395(10229):1033-4. Available from: https://pubmed.ncbi.nlm.nih.gov/32192578/. doi: 10.1016/S0140-6736(20)30628-0
24. Karki R, Kanneganti TD. The 'cytokine storm': molecular mechanisms and therapeutic prospects. Trends Immunol [Internet]. 2021[cited 2024 Jan 14];42(8):681-705. Available from: https://pubmed.ncbi.nlm.nih.gov/34217595/. doi: 10.1016/j.it.2021.06.001
25. Badawi A. Hypercytokinemia and pathogen-host interaction in COVID-19. J Inflamm Res [Internet]. 2020 [cited 2024 Jan 14]; 13:255-61. Available from: https://pubmed.ncbi.nlm.nih.gov/32606886/#:~:text=Understanding%20the%20nature%20of%20pathogen,the%20spread%20of%20the%20disease. doi: 10.2147/JIR.S259096
26. Fajgenbaum DC, June CH. Cytokine storm. N Engl J Med [Internet]. 2020 [cited 2024 Jan 14];383(23):2255-73. Available from: https://www.nejm.org/doi/full/10.1056/NEJMra2026131. doi: 10.1056/NEJMra2026131
27. Liu Ch, Chu D, Kalantar-Zadeh K, George J, Young HA, Liu G. Cytokines: From clinical significance to quantification. Adv Sci (Weinh) [Internet]. 2021 [cited 2024 Jan 14];8 (15): e2004433. Available from: https://pubmed.ncbi.nlm.nih.gov/34114369/. doi: 10.1002/advs.202004433
28. Vanderbeke L, Van Mol P, Van Herck Y, De Smet F, Humblet-Baron S, Martinod K, et al. Monocyte-driven atypical cytokine storm and aberrant neutrophil activation as key mediators of COVID-19 disease severity. Nat Commun [Internet]. 2021 [cited 2024 Jan 14]; 12(1): 4117. Available from: https://pubmed.ncbi.nlm.nih.gov/34226537/. doi: 10.1038/s41467-021-24360-w
29. Tang XD, Ji TT, Dong JR, Feng H, Chen FQ, Chen X, Zhao HY, Chen DK, Ma WT. Pathogenesis and treatment of cytokine storm induced by infectious diseases. Int J Mol Sci [Internet]. 2021 [cited 2024 Jan 14];22(23):13009. Available from: https://pubmed.ncbi.nlm.nih.gov/34884813/. doi: 10.3390/ijms222313009
30. Pant A, Mackraj I, Govender T. Advances in sepsis diagnosis and management: a paradigm shift towards nanotechnology. J Biomed Sci [Internet]. 2021 [cited 2023 Mar 14];28(1):6. Available from: https://pubmed.ncbi.nlm.nih.gov/33413364/. doi: 10.1186/s12929-020-00702-6
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