2020年10月19日，美国杜克大学医学中心Niccol Terrando课题组在《自然-免疫学》上发表了关于术后神经炎症的综述文章。

在本综述中，研究人员讨论了外科手术后免疫系统影响中枢神经系统的潜在机制。这些神经免疫相互作用共同成为多种神经系统疾病（包括那些由手术引起的神经系统疾病）的标志和潜在治疗靶标。

据了解，损伤是诱发炎症的主要原因，炎症是一种关键且必要的反应，包括多种调控组织稳态恢复的介质。多种刺激可引起中枢神经系统炎症，其中一些刺激是大脑固有的，而其他刺激则来源于周围信号。在衰老和持续性神经退行性病变造成的系统中，对此反应的微调至关重要。

在这种情况下，看似无害的干预措施，如修复断肢的普通手术，可能会使免疫系统不堪重负，并造成诸如神经失常和其他手术引起的神经认知障碍等损伤。

附：英文原文

Title: Neuroinflammation after surgery: from mechanisms to therapeutic targets

Author: Ting Yang, Ravikanth Velagapudi, Niccol Terrando

Issue&Volume: 2020-10-19

Abstract: Injury is a key driver of inflammation, a critical yet necessary response involving several mediators that is aimed at restoring tissue homeostasis. Inflammation in the central nervous system can be triggered by a variety of stimuli, some intrinsic to the brain and others arising from peripheral signals. Fine-tuned regulation of this response is crucial in a system that is vulnerable due to, for example, aging and ongoing neurodegeneration. In this context, seemingly harmless interventions like a common surgery to repair a broken limb can overwhelm the immune system and become the driver of further complications such as delirium and other perioperative neurocognitive disorders. Here, we discuss potential mechanisms by which the immune system affects the central nervous system after surgical trauma. Together, these neuroimmune interactions are becoming hallmarks of and potential therapeutic targets for multiple neurologic conditions, including those affecting the perioperative space. Terrando and colleagues review key mechanisms related to postoperative inflammation and the implications for developing perioperative neurocognitive disorders, with a focus on neuroinflammation and key cellular targets affected by surgical trauma.

DOI: 10.1038/s41590-020-00812-1

Source: https://www.nature.com/articles/s41590-020-00812-1