腹腔区域免疫特性:复杂性腹腔感染向腹腔脓毒症演进的关键机制与临床意义OA

This review systematically delineates the clinical and pathophysiological features of complicated intra-abdominal infection(cIAI)and intra-abdominal sepsis(IAS),with a particular focus on their intrinsic association with the compartment-specific immune characteristics of the peritoneal cavity.IAS typically evolves from cIAI and represents a distinct immunopathological entity compared with sepsis originating from other anatomical sites,characterized by rapid onset,accelerated disease progression,and high mortality.The underlying basis of this process lies in the highly sensitive regional immune defense system of the peritoneal cavity,composed of specialized immune units including milky spots,peritoneal resident macrophages(PRM),B1 cells,and innate lymphoid cells(ILC).Following the onset of cIAI,this immune network is rapidly activated,generating an intense localized inflammatory response that facilitates early containment and clearance of invading pathogens.However,when local immune regulation becomes dysbalanced or effective pathogen control fails,the relatively confined anatomy of the peritoneal cavity,together with its dense vascular and lymphatic networks,instead promotes sustained inflammatory amplification and rapid systemic dissemination,thereby driving the development and progression of IAS.Future studies should therefore focus on elucidating the dynamic remodeling of peritoneal regional immunity after infection and the key mechanisms governing its transition from localized activation to systemic involvement.Such insights,built upon existing therapeutic frameworks,may provide a novel biological basis for early risk identification,disease course assessment,and mechanism-informed intervention strategies,ultimately contributing to improved clinical outcomes in patients with cIAI and IAS.