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中华诊断学电子杂志 ›› 2015, Vol. 03 ›› Issue (02) : 118 -121. doi: 10.3877/cma.j.issn.2095-655X.2015.02.010

所属专题: 文献

临床思维

神经内分泌反应与创伤感染早期诊治关系的思考
杨策1,(), 杜娟1, 王海燕1, 杨学涛1, 蒋建新1   
  1. 1. 400042 重庆,第三军医大学野战外科研究所 创伤烧伤与复合伤国家重点实验室
  • 收稿日期:2014-12-29 出版日期:2015-05-26
  • 通信作者: 杨策
  • 基金资助:
    国家"973"课题(2012CB518102); 国家自然科学基金(81372105,31271242); 全军"十二五"重大项目(AWS14C003)

Thinking of the relationship between neuroendocrine responses and clinical diagnosis as well as therapy in the early phase of trauma

Ce Yang1,(), Juan Du1, Haiyan Wang1, Xuetao Yang1, Jianxin Jiang1   

  1. 1. Department of State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Surgery Research, Third Military Medical University, Chongqing 400042, China
  • Received:2014-12-29 Published:2015-05-26
  • Corresponding author: Ce Yang
  • About author:
    Corresponding author: Yang Ce, Email:
引用本文:

杨策, 杜娟, 王海燕, 杨学涛, 蒋建新. 神经内分泌反应与创伤感染早期诊治关系的思考[J/OL]. 中华诊断学电子杂志, 2015, 03(02): 118-121.

Ce Yang, Juan Du, Haiyan Wang, Xuetao Yang, Jianxin Jiang. Thinking of the relationship between neuroendocrine responses and clinical diagnosis as well as therapy in the early phase of trauma[J/OL]. Chinese Journal of Diagnostics(Electronic Edition), 2015, 03(02): 118-121.

在创伤发生、发展过程中,神经内分泌和免疫系统作为机体病理生理变化的"领航者" ,彼此间存在着密切的双向信息传递机制。神经内分泌学与免疫学相互渗透、彼此交融并能向创伤医学领域拓展,其根本原因在于神经、内分泌和免疫三大系统拥有共同的生物学语言,即共享激素、神经递质、神经肽和细胞因子等化学信息分子及其受体,免疫系统不仅受神经、内分泌系统的调控,还能调节神经内分泌系统的某些功能。三大系统的交互联动促使创伤感染病程呈现出复杂多变的时空规律。近年研究提出,以神经内分泌反应为始动因素、免疫细胞为调控环节、免疫调控分子为效应靶点引发创伤后免疫功能紊乱的网络联动模式,为从转化医学视角对创伤感染的临床诊治提供了有益的启示。

During the occurrence and development of wounds, the neurosecretory and immune systems act as a prominent leader navigator and possess an intrinsic crosstalk in the reciprocal information dissemination.The fundamental reason is that neuroendocrinology and immunology could mix with each other and permeate mutually.It is owing to their same biological languages or chemical information molecules (hormones, neurotransmitters, neuropeptides, cytokines and their corresponding receptors) shared by the neuroendocrine and immune systems.The immune system is modulated by the neuroendocrine system, and can modulate the biological functions of neuroendocrine system at the same time.The interactive linkage of these three systems precipitates the complicated space-time patterns for the courses of traumatic infections.Recently compelling evidences indicated that the network linkage pattern with neuroendocrine responses as initiating agents, immune cells as regulatory elements and immune regulatory molecules as effector targets arouse immune dysfunction after trauma, which supplies the beneficial enlightenment for the clinical diagnosis and therapy concerning the view of translation medicine.

[1]
Sternberg EM.Neural regulation of innate immunity:a coordinated nonspecific host response to pathogens[J]. Nat Rev Immunol, 2006, 6(4): 318-328.
[2]
Haddad JJ.On the mechanisms and putative pathways involving neuroimmune interactions[J]. Biochem Biophys Res Commun, 2008, 370(4): 531-535.
[3]
De la Fuente M. Crosstalk between the nervous and the immune systems in health and sickness[J]. Curr Pharm Des, 2014, 20(29): 4605-4607.
[4]
Wrona D. Neural-immune interactions:an integrative view of the bidirectional relationship between the brain and immune systems[J]. J Neuroimmunol, 2006, 172(1-2): 38-58.
[5]
Mracsko E,Liesz A,Karcher S, et al.Differential effects of sympathetic nervous system and hypothalamic-pituitary-adrenal axis on systemic immune cells after severe experimental stroke[J]. Brain Behav Immun, 2014(41): 200-209.
[6]
Yang C,Jiang JX.Bilateral regulatory action of corticotropin-releasing hormone on immune-mediated inflammation[J]. Chin J Traumatol, 2009, 12(6): 350-354.
[7]
Yang C,Gao J,Wang HY, et al.Effects of hypothalamus destruction on the level of plasma corticosterone after blast injury and its relation to interleukin-6 in rats[J]. Cytokine, 2010, 54(1): 29-35.
[8]
Yang C,Yan J,Wang HY, et al.Effects of bilateral adrenalectomy on the innate immune responses following trauma in rats[J]. Injury, 2011, 42(9): 905-912.
[9]
Gadek-Michalska A,Tadeusz J,Rachwalska P, et al.Cytokines, prostaglandins and nitric oxide in the regulation of stress-response systems[J]. Pharmacol Rep, 2013, 65(6): 655-1662.
[10]
Ma XC,Chen LT,Oliver J, et al.Cytokine and adrenal axis responses to endotoxin[J]. Brain Res, 2000, 861(1): 135-142.
[11]
Ji MH,Zhu XL,Liu FF, et al.Alpha 2A-adrenoreceptor blockade improves sepsis-induced acute lung injury accompanied with depressed high mobility group box-1 levels in rats[J]. Cytokine, 2012, 60(3): 639-645.
[12]
Kandasamy K,Prawez S,Choudhury S, et al.Atorvastatin prevents vascular hyporeactivity to norepinephrine in sepsis:role of nitric oxide and α-adrenoceptor mRNA expression[J]. Shock, 2011, 36(1): 76-82.
[13]
Zhou M,Das P,Simms HH, et al.Gut-derived norepinephrine plays an important role in up-regulating IL-1beta and IL-10[J]. Biochim Biophys Acta, 2005, 1740(3): 446-452.
[14]
Zhang F,Wu R,Qiang X, et al.Antagonism of alpha2A-adrenoceptor:a novel approach to inhibit inflammatory responses in sepsis[J]. J Mol Med(Berl), 2010, 88(3): 289-296.
[15]
Miksa M,Wu R,Zhou M, et al.Sympathetic excitotoxicity in sepsis:pro-inflammatory priming of macrophages by norepinephrine[J]. Front Biosci, 2005(10): 2217-2229.
[16]
Borovikova LV,Ivanova S,Zhang M, et al.Vagus nerve stimulation attenuates the systemic inflammatory response to endotoxin[J]. Nature, 2000, 405(6785): 458-462.
[17]
Pavlov VA,Parrish WR,Rosas-Ballina M, et al.Brain acetylcholinesterase activity controls systemic cytokine levels through the cholinergic anti-inflammatory pathway[J]. Brain Behav Immun, 2009, 23(1): 41-45.
[18]
Altavilla D1,Guarini S,Bitto A, et al.Activation of the cholinergic anti-inflammatory pathway reduces NF-kappab activation, blunts TNF-alpha production, and protects againts splanchic artery occlusion shock.Shock[J], 2006, 25(5): 500-506.
[19]
Mózsik G,Dömötör A,Abdel-Salam OM.Molecular pharmacological approach to drug actions on the afferent and efferent fibres of the vagal nerve involved in gastric mucosal protection in rats[J]. Inflammopharmacology, 2006, 14(5-6): 243-249.
[21]
Bernik TR,Friedman SG,Ochani M, et al.Pharmacological stimulation of the cholinergic antiinflammatory pathway[J]. J Exp Med, 2002, 195(6): 781-788.
[22]
Jiang JX.Posttraumatic stress and immune dissonance[J]. Chin J Traumatol, 2008, 11(4): 203-208.
[23]
杨志寅. 现代医学科学发展中的缺憾与思考[J/CD]. 中华诊断学电子杂志, 2013, 1(1): 1-7.
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