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首页> 外文期刊>Current opinion in anaesthesiology >Targeting the lipopolysaccharides: still a matter of debate?
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Targeting the lipopolysaccharides: still a matter of debate?

机译：针对脂多糖：还有争议吗？

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PURPOSE OF REVIEW: The intention of this article is to review endotoxin, host response to endotoxin, clinical significance of endotoxemia, past failed therapies targeting endotoxin, current therapeutic efforts in this area and the authors' opinion on the future of such therapy. RECENT FINDINGS: Endotoxin or lipopolysaccharide is implicated in the activation of cytokine release with the potential to lead to severe sepsis. Therapies targeting endotoxin are very appealing and remain a matter of study and debate. Antiendotoxin antibody studies did not show consistent benefit to warrant its approval for use. Lipid A analog, phospholipid emulsion, and ethyl pyruvate are currently being evaluated for potential clinical use. Polymyxin B as an antiendotoxin strategy has an unacceptable toxicity profile for routine use as an intravenous agent and its use in plasmapheris is too cumbersome. Curcumin and lipopolysaccharide binding peptides, although having a potentially desirable effect on ameliorating endotoxin toxicity, remain to be shown effective in clinical trials. The development of a vaccine against endotoxin carries promise. SUMMARY: The benefits of therapies targeting endotoxin remain to be elucidated. Clinical trials targeting populations with documented endotoxemia are more likely to provide an adequate test of this therapeutic approach. Prophylaxis of high-risk populations should also be considered.
机译：审查目的：本文旨在综述内毒素，宿主对内毒素的反应，内毒素血症的临床意义，以往针对内毒素的失败疗法，该领域目前的治疗努力以及作者对该疗法的未来看法。最近发现：内毒素或脂多糖与细胞因子释放的激活有关，可能导致严重的败血症。靶向内毒素的疗法非常有吸引力，仍然是研究和辩论的问题。抗内毒素抗体研究没有显示出一致的益处以保证其使用许可。脂质A类似物，磷脂乳液和丙酮酸乙酯目前正在评估潜在的临床用途。多粘菌素B作为一种抗内毒素策略，对于常规用作静脉注射剂的毒性特征是不可接受的，并且其在血浆中的使用也很麻烦。姜黄素和脂多糖结合肽尽管对改善内毒素毒性具有潜在的理想作用，但在临床试验中仍显示有效。抗内毒素疫苗的开发有望实现。摘要：靶向内毒素的疗法的益处仍有待阐明。针对已证明有内毒素血症人群的临床试验更有可能对该治疗方法提供充分的测试。还应考虑预防高危人群。

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