脓毒症时外周血白细胞首先发生炎症激活,随着炎症进展,机体进入免疫耐受状态.过度炎症期,单核/巨噬细胞有氧糖酵解和磷酸戊糖途径增加,氧化磷酸化受到抑制;但免疫耐受期,糖酵解受到抑制.总结分析脓毒症时单核/巨噬细胞代谢通路的改变,以及葡萄糖、氨基酸和脂肪酸代谢对脓毒症时单核/巨噬细胞的影响,表明脓毒症时细胞代谢对单核/巨噬细胞免疫功能具有重要的调控作用,调控免疫细胞代谢产物或与其相关的信号通路,可能是治疗脓毒症的潜在方法.
During sepsis, circulating leukocytes are in a hyper inflammatory state, and with the progress of the inflammation, immune cells may become tolerated. Glycolysis and pentose phosphate pathway are up-regulated but oxidative phosphorylation is suppressed in hyper inflammatory cells, whereas during immune tolerance, glycolysis is often down-regulated. In this review, we will summarize the changes of cellular metabolic pathways in monocytes and macrophages during sepsis. We also review how the metabolism of glucose, amino acids, and fatty acids affect the function of monocytes and macrophages in sepsis. Current literature indicated that metabolism plays a significant role in regulating the functions of immune cells in sepsis, which might be a potential therapy for sepsis and deserved further research.