细胞外囊泡在脓毒症治疗中的新进展与机制解析

Extracellular vesicles in sepsis therapy: Mechanistic insights and emerging strategies

摘要

脓毒症是一种因机体对感染反应失调而产生的全身性炎症与免疫功能紊乱综合征，病程复杂、死亡率高，目前主要依靠抗感染和器官支持，缺少针对免疫与炎症失衡的有效干预手段；近年来，细胞外囊泡（EVs）作为细胞间信息传递的关键载体，由于其在免疫调控、炎症缓解及组织修复方面的作用被广泛重视。本文系统梳理了不同来源EVs（包含间充质干细胞、免疫细胞、内皮细胞及血小板衍生）在脓毒症中的作用机理及其实验进展，着重讨论它们在调节炎症反应、恢复免疫平衡并减轻器官损伤方面的潜力。同时，结合工程化改造和药物递送策略，探究EVs作为新型生物制剂的转化方向以及遇到的难题，展望其研究前景和发展的关键。

Abstract

Sepsis means a kind of condition, where an imbalanced host reaction to infection causes systemic inflammation and dysfunction in immune system; such condition has complicated pathological and physiological mechanisms with high mortality rates. Today's treatments mainly depend on anti‐microbial therapies and organs supporting care but do not involve intervention regarding immunological imbalance or imbalance in inflammatory responses. In recent years, extracellular vesicles (EVs), which are key mediators of intercellular communication, have attracted increasing attention because they can regulate immunity, suppress inflammation, and repair tissue damage. This paper thoroughly reviews the mechanisms as well as advancements related to EV from mesenchymal stem cells, immune cell‐derived EVs, endothelial cell‐derived EVs and platelet EVs for sepsis, paying more attention on its potential to alter inflammatory responses, to bring back immune balance, and to relieve organ injuries. It then introduces new ideas about EV engineering and drug delivery methods and looks at whether EV could be turned into biological medicines as well as problems that would get in the way. The article aims to provide some understanding about basic research as well as cross national research involving usage of EV therapy in sepsis patients, also mentions certain possibilities and vital routes ahead so that such therapy becomes easily obtainable for clinical purposes.

关键词

脓毒症 / 细胞外囊泡 / 外泌体 / 免疫调节 / 生物治疗

Key words

Sepsis / Extracellular Vesicles / Exosomes / Immunomodulation / Biotherapy

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基金资助

新发突发与重大传染病防控国家科技重大专项(2025ZD01902600)

国家自然科学基金青年项目(82202409)