Science review Extracellular acidosis and the immune response clinical and physiologic implications 英文参考文献.docVIP

Available online /content/8/5/331 Review Science review: Extracellular acidosis and the immune response: clinical and physiologic implications John A Kellum1, Mingchen Song2 and Jinyou Li3 1Associate Professor, Critical Care Medicine and Medicine, Co-Director, The MANTRA (Mechanisms And Novel Therapies for Resuscitation and Acute illness) Laboratory, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA 2Research Fellow, Department of Critical Care Medicine, The MANTRA Laboratory, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA 3Visiting Researcher, Department of Critical Care Medicine, The MANTRA Laboratory, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA Corresponding author: John A Kellum, kellumja@ Published online: 16 June 2004 Critical Care 2004, 8:331-336 (DOI 10.1186/cc2900) This article is online at /content/8/5/331 ? 2004 BioMed Central Ltd Abstract Metabolic acidosis is among the most common abnormalities seen in patients suffering from critical illness. Its etiologies are multiple and treatment of the underlying condition is the mainstay of therapy. However, growing evidence suggests that acidosis itself has profound effects on the host, particularly in the area of immune function. Given the central importance of immune function to the outcome of critical illness, there is renewed interest in elucidating the effects of this all too common condition on the immune response. In this review we concentrate on the effects of extracellular acids on production and release of inflammatory mediators, and we demonstrate that different acids produce different effects despite similar extracellular pH. Finally, we discuss potential clinical implications. Keywords acidosis, cytokines, immune response, pH, sepsis Introduction injury results in increased s