期刊
NEPHRON CLINICAL PRACTICE
卷 127, 期 1-4, 页码 153-157出版社
KARGER
DOI: 10.1159/000363255
关键词
Cholinergic anti-inflammatory pathway; Acetylcholine; Ultrasound; Inflammation; Sepsis
资金
- National Institutes of Health [R01 DK062324, R21 093841, T32 DK072922]
- NIH UAB-UCSD O'Brien Center [P30 DK079337]
- NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES [T32DK072922, R01DK062324] Funding Source: NIH RePORTER
Acute kidney injury (AKI) is an increasing medical burden and is independently associated with mortality. AKI is a common comorbidity in the intensive care unit (ICU), with sepsis-associated AKI seen in almost a quarter of all ICU patients. Due to the high mortality seen in these patients, improved therapeutic options are needed. Data from experimental studies in animals support observations in humans that the host immune response to sepsis and trauma contributes to multiorgan failure and the high morbidity and mortality seen in critically ill patients. The spleen, a major component of the reticuloendothelial system, appears to be a key player in the cytokine storm' that develops after infection and trauma, and the resultant systemic inflammation is regulated by the autonomic nervous system. Over the past decade, evidence has suggested that controlling the splenic cytokine response improves tissue function and mortality in sepsis and other inflammatory-mediated diseases. One pathway that controls the response of the spleen to sepsis and trauma is the cholinergic anti-inflammatory pathway, and it may provide a key target for therapeutic intervention. Here, we review this concept and highlight the potential use of ultrasound to stimulate the cholinergic anti-inflammatory pathway and reduce systemic inflammation and disease severity. (C) 2014 S. Karger AG, Basel.
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