免疫調節を行うために必要な免疫学的モニタリング

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  • Monitoring of Immune Responses in Critically Ill Patients for Selecting Candidates for Immunomodulation Therapy

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Activation of host defense mechanisms in response to surgical stress is essential for preserving internal homeostasis. When the inflammatory response involved in tissue repair is too strong, serious collateral damage to normal tissues can result. On the other hand, excessive immune suppression will compromise the host. Such acquired “immunoparalysis” may represent a risk factor for secondary infections and could contribute to late mortality from sepsis. This article describes the importance of well-calibrated inflammation and immune responses for recovery from tissue damage; immune imbalance as a case of rapidly progressive cell damage and multiple organ failure; and desirability of appropriate immunomodulatary treatment that maintain immune status by judicious use of immune activating or suppressive agents. Such immunomodulation requires appropriate immunologic monitoring to assess T-helper (Th1/Th2) lymphocyte subset balance; expression of HLADR by monocytes; capacity for cytokine production; and neutrophil function.

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