中性粒细胞
炎症
免疫学
免疫系统
医学
先天免疫系统
获得性免疫系统
器官功能障碍
免疫
吞噬作用
败血症
作者
Pieter H. C. Leliefeld,Catharina M. Wessels,Luke P. H. Leenen,Leo Koenderman,Janesh Pillay
出处
期刊:Critical Care
[Springer Nature]
日期:2016-03-23
卷期号:20 (1)
被引量:191
标识
DOI:10.1186/s13054-016-1250-4
摘要
Critically ill post-surgical, post-trauma and/or septic patients are characterised by severe inflammation. This immune response consists of both a pro- and an anti-inflammatory component. The pro-inflammatory component contributes to (multiple) organ failure whereas occurrence of immune paralysis predisposes to infections. Strikingly, infectious complications arise in these patients despite the presence of a clear neutrophilia. We propose that dysfunction of neutrophils potentially increases the susceptibility to infections or can result in the inability to clear existing infections. Under homeostatic conditions these effector cells of the innate immune system circulate in a quiescent state and serve as the first line of defence against invading pathogens. In severe inflammation, however, neutrophils are rapidly activated, which affects their functional capacities, such as chemotaxis, phagocytosis, intra-cellular killing, NETosis, and their capacity to modulate adaptive immunity. This review provides an overview of the current understanding of neutrophil dysfunction in severe inflammation. We will discuss the possible mechanisms of downregulation of anti-microbial function, suppression of adaptive immunity by neutrophils and the contribution of neutrophil subsets to immune paralysis.
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