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已发表论文
脓毒症免疫调节、器官功能障碍及治疗中的双向调节作用
Authors Zhang M, Xie J, Zhang P, Wang L, Wang Q, Yin W
Received 26 May 2025
Accepted for publication 29 October 2025
Published 7 November 2025 Volume 2025:20 Pages 13527—13541
DOI https://doi.org/10.2147/IJN.S542937
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 5
Editor who approved publication: Prof. Dr. RDK Misra
Meng Zhang,1– 4 Jiangang Xie,3,4 Peiyu Zhang,1 Linxiao Wang,5 Qianmei Wang,1 Wen Yin1
1Department of Emergency, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China; 2School of Medicine, Northwest University, Xi’an, Shaanxi, 710069, People’s Republic of China; 3Department of Interventional Vascular, The Affiliated Hospital of Northwest University, Xi’an, Shaanxi, People’s Republic of China; 4Xi’an Key Laboratory of Metabolic Disease Imaging, The Affiliated Hospital of Northwest University, Xi’an, Shaanxi, People’s Republic of China; 5Department of Emergency, Honghui Hospital, Xi’an Jiao Tong University, Xi’an, Shaanxi, 710054, People’s Republic of China
Correspondence: Wen Yin, Department of Emergency, Xijng Hospital, Air Force Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China, Email xjyyyw@fmmu.edu.cn
Abstract: Exosomes have emerged as central mediators in sepsis pathogenesis and therapy. Exosomes play an important role in cell communication by transferring functional proteins, metabolites, and nucleic acids to recipient cells. Recently, Low-immunogenic exosomes serve as novel biomarkers in sepsis, and they confer a 46% enhancement in survival benefit in animal models. However, exosomes drive the early inflammatory storm and late immune paralysis in sepsis. There are also limitations related to heterogeneity and translational barriers. Therefore, this review discusses the basic signaling pathways underlying the bidirectional effects of exosomes in the pathogenesis and treatment of sepsis, the interaction between organ dysfunction and exosomes in sepsis, the current progress in exosome therapy for sepsis, as well as the challenges and limitations faced in this field. In summary, exosomes have bright prospects in diagnosis and clinical translation, as well as the potential for standardized production.
Keywords: extracellular vesicles, biomarkers, immunomodulation, exosomes, sepsis, bidirectional regulatory roles
1Department of Emergency, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China; 2School of Medicine, Northwest University, Xi’an, Shaanxi, 710069, People’s Republic of China; 3Department of Interventional Vascular, The Affiliated Hospital of Northwest University, Xi’an, Shaanxi, People’s Republic of China; 4Xi’an Key Laboratory of Metabolic Disease Imaging, The Affiliated Hospital of Northwest University, Xi’an, Shaanxi, People’s Republic of China; 5Department of Emergency, Honghui Hospital, Xi’an Jiao Tong University, Xi’an, Shaanxi, 710054, People’s Republic of China
Correspondence: Wen Yin, Department of Emergency, Xijng Hospital, Air Force Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China, Email xjyyyw@fmmu.edu.cn
Abstract: Exosomes have emerged as central mediators in sepsis pathogenesis and therapy. Exosomes play an important role in cell communication by transferring functional proteins, metabolites, and nucleic acids to recipient cells. Recently, Low-immunogenic exosomes serve as novel biomarkers in sepsis, and they confer a 46% enhancement in survival benefit in animal models. However, exosomes drive the early inflammatory storm and late immune paralysis in sepsis. There are also limitations related to heterogeneity and translational barriers. Therefore, this review discusses the basic signaling pathways underlying the bidirectional effects of exosomes in the pathogenesis and treatment of sepsis, the interaction between organ dysfunction and exosomes in sepsis, the current progress in exosome therapy for sepsis, as well as the challenges and limitations faced in this field. In summary, exosomes have bright prospects in diagnosis and clinical translation, as well as the potential for standardized production.
Keywords: extracellular vesicles, biomarkers, immunomodulation, exosomes, sepsis, bidirectional regulatory roles