烧伤感染与免疫紊乱：从发病机制到精准诊疗的转化医学新视野

姚咏明; 任超

doi:10.3760/cma.j.cn501225-20251104-00457

烧伤感染与免疫紊乱：从发病机制到精准诊疗的转化医学新视野

doi: 10.3760/cma.j.cn501225-20251104-00457

姚咏明^1, ,,
任超²

1.
解放军总医院医学创新研究部、第四医学中心,北京　100853
2.
首都医科大学附属北京朝阳医院呼吸与危重医学科,北京　100020

基金项目:

国家重点研发计划 2022YFA1104600

国家自然科学基金重点项目 82130062

详细信息

通讯作者:
姚咏明,Email：c_ff@sina.com

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出版历程
- 收稿日期: 2025-11-04
- 网络出版日期: 2026-01-30

Postburn infection and immune dysfunction: new translational horizons from the pathogenesis to precision medicine

Yao Yongming^{1
, ,},
Ren Chao²

1.
Medical Innovation Research Division and the Fourth Medical Center of the Chinese PLA General Hospital, Beijing 100853, China
2.
Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China

Funds:

National Key Research and Development Program of China 2022YFA1104600

Key Program of National Natural Science Foundation of China 82130062

More Information

Corresponding author: Yao Yongming, Email: c_ff@sina.com

摘要

摘要: 烧伤后皮肤屏障破坏与免疫紊乱的“病理恶性循环”,使感染成为患者主要并发症及重要死亡原因,其中烧伤脓毒症病例占总死亡病例的50%以上。目前对于烧伤感染的防治面临诸多难题：感染引发失控性炎症反应与免疫紊乱的叠加效应,局部创面向全身性级联损害快速进展,多重耐药菌大量滋生极大增加抗菌治疗的难度。本文对烧伤感染后免疫功能障碍的机制从现象到本质进行深入分析,系统阐述多重耐药菌免疫逃逸、免疫平衡失调、肠道菌群及新型免疫调节细胞在机体免疫紊乱中的重要作用及效应机制；结合智能创面监测系统及新型生物标志物的最新进展,介绍烧伤感染评估及免疫监测的新技术；聚焦烧伤后靶向免疫调控与局部微环境重塑的治疗新策略,进一步解析新的诊疗策略的临床转化挑战与未来发展方向。
- 烧伤 /
- 感染 /
- 免疫障碍 /
- 精准诊疗 /
- 转化医学
Abstract: The "pathological vicious cycle" between skin barrier disruption and immune dysfunction renders infection a primary complication and main cause of death among burn patients. Burn-related sepsis patients account for more than 50% of all burn-associated deaths. Currently, the prevention and treatment of burn infections are confronted with multiple challenges: the superimposed effects of uncontrolled inflammatory response and immune disorder triggered by infection, the rapid progression from local wound to systemic damage, and the massive colonization of multidrug-resistant bacteria, which significantly increases the difficulty of antibacterial therapy. This paper conducted an in-depth analysis of the mechanisms underlying immune dysfunction after burn-related infections from phenotypic manifestations to intrinsic regulation. It systematically elaborated on the crucial roles and mechanisms in the pathogenesis of immune dysfunction, including immune evasion of multidrug-resistant bacteria, the failed balance of immune responses, intestinal flora, and novel subtypes of immune regulatory cells. This paper further reported the emerging technologies for infection assessment and immune monitoring among burn patients by integrating the latest advancements in intelligent wound detecting system and novel biomarkers. Focusing on innovative therapeutic strategies targeting postburn immune regulation and local microenvironment remodeling, it further analyzed the challenges in clinical translation and future development directions.
- Burns /
- Infection /
- Immune dysfunction /
- Precision diagnosis and treatment /
- Translational medicine
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