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Yang Z, Gao Y, Zhao L, Lv X, Du Y. Molecular mechanisms of Sepsis attacking the immune system and solid organs. Front Med (Lausanne) 2024; 11:1429370. [PMID: 39267971 PMCID: PMC11390691 DOI: 10.3389/fmed.2024.1429370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 08/15/2024] [Indexed: 09/15/2024] Open
Abstract
Remarkable progress has been achieved in sepsis treatment in recent times, the mortality rate of sepsis has experienced a gradual decline as a result of the prompt administration of antibiotics, fluid resuscitation, and the implementation of various therapies aimed at supporting multiple organ functions. However, there is still significant mortality and room for improvement. The mortality rate for septic patients, 22.5%, is still unacceptably high, accounting for 19.7% of all global deaths. Therefore, it is crucial to thoroughly comprehend the pathogenesis of sepsis in order to enhance clinical diagnosis and treatment methods. Here, we summarized classic mechanisms of sepsis progression, activation of signal pathways, mitochondrial quality control, imbalance of pro-and anti- inflammation response, diseminated intravascular coagulation (DIC), cell death, presented the latest research findings for each mechanism and identify potential therapeutic targets within each mechanism.
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Affiliation(s)
- Zhaoyun Yang
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Jilin University, Changchun, China
- Department of Rehabilitation, School of Nursing, Jilin University, Changchun, China
| | - Yan Gao
- State Key Laboratory of Chemo/Biosensing and Chemometrics, College of Biomedical Sciences, College of Chemistry and Chemical Engineering, Hunan University, Changsha, China
| | - Lijing Zhao
- Department of Rehabilitation, School of Nursing, Jilin University, Changchun, China
| | - Xuejiao Lv
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Jilin University, Changchun, China
| | - Yanwei Du
- Department of Rehabilitation, School of Nursing, Jilin University, Changchun, China
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2
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Forceville X, Van Antwerpen P, Preiser JC. Selenocompounds and Sepsis: Redox Bypass Hypothesis for Early Diagnosis and Treatment: Part A-Early Acute Phase of Sepsis: An Extraordinary Redox Situation (Leukocyte/Endothelium Interaction Leading to Endothelial Damage). Antioxid Redox Signal 2021; 35:113-138. [PMID: 33567962 DOI: 10.1089/ars.2020.8063] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Significance: Sepsis is a health disaster. In sepsis, an initial, beneficial local immune response against infection evolves rapidly into a generalized, dysregulated response or a state of chaos, leading to multiple organ failure. Use of life-sustaining supportive therapies creates an unnatural condition, enabling the complex cascades of the sepsis response to develop in patients who would otherwise die. Multiple attempts to control sepsis at an early stage have been unsuccessful. Recent Advances: Major events in early sepsis include activation and binding of leukocytes and endothelial cells in the microcirculation, damage of the endothelial surface layer (ESL), and a decrease in the plasma concentration of the antioxidant enzyme, selenoprotein-P. These events induce an increase in intracellular redox potential and lymphocyte apoptosis, whereas apoptosis is delayed in monocytes and neutrophils. They also induce endothelial mitochondrial and cell damage. Critical Issues: Neutrophil production increases dramatically, and aggressive immature forms are released. Leukocyte cross talk with other leukocytes and with damaged endothelial cells amplifies the inflammatory response. The release of large quantities of reactive oxygen, halogen, and nitrogen species as a result of the leukocyte respiratory burst, endothelial mitochondrial damage, and ischemia/reperfusion processes, along with the marked decrease in selenoprotein-P concentrations, leads to peroxynitrite damage of the ESL, reducing flow and damaging the endothelial barrier. Future Directions: Endothelial barrier damage by activated leukocytes is a time-sensitive event in sepsis, occurring within hours and representing the first step toward organ failure and death. Reducing or stopping this event is necessary before irreversible damage occurs.
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Affiliation(s)
- Xavier Forceville
- Medico-Surgical Intensive Care Unit, Great Hospital of East Francilien-Meaux Site, Hôpital Saint Faron, Meaux, France.,Clinical Investigation Center (CIC Inserm 1414), CHU de Rennes, Université de Rennes 1, Rennes, France
| | - Pierre Van Antwerpen
- Pharmacognosy, Bioanalysis and Drug Discovery and Analytical Platform of the Faculty of Pharmacy, Université libre de Bruxelles (ULB), Bruxelles, Belgium
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3
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Tindal EW, Armstead BE, Monaghan SF, Heffernan DS, Ayala A. Emerging therapeutic targets for sepsis. Expert Opin Ther Targets 2021; 25:175-189. [PMID: 33641552 PMCID: PMC8122062 DOI: 10.1080/14728222.2021.1897107] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/25/2021] [Indexed: 12/11/2022]
Abstract
Introduction: Sepsis is characterized by a dysregulated host response to infection. Sepsis-associated morbidity/mortality demands concerted research efforts toward therapeutic interventions which are reliable, broadly effective, and etiologically based. More intensive and extensive investigations on alterations in cellular signaling pathways, gene targeting as a means of modifying the characteristic hyper and/or hypo-immune responses, prevention through optimization of the microbiome, and the molecular pathways underlying the septic immune response could improve outcomes.] Areas covered: The authors discuss key experimental mammalian models and clinical trials. They provide an evaluation of evolving therapeutics in sepsis and how they have built upon past and current treatments. Relevant literature was derived from a PubMed search spanning 1987-2020.Expert opinion: Given the complex nature of sepsis and the elicited immune response, it is not surprising that a single cure-all therapeutic intervention, which is capable of effectively and reliably improving patient outcomes has failed to emerge. Innovative approaches seek to address not only the disease process but modify underlying patient factors. A true improvement in sepsis-associated morbidity/mortality will require a combination of unique therapeutic modalities.
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Affiliation(s)
- Elizabeth W Tindal
- Division of Surgical Research, Department of Surgery, Brown University, Rhode Island Hospital, Providence, RI, USA
| | - Brandon E Armstead
- Division of Surgical Research, Department of Surgery, Brown University, Rhode Island Hospital, Providence, RI, USA
| | - Sean F Monaghan
- Division of Surgical Research, Department of Surgery, Brown University, Rhode Island Hospital, Providence, RI, USA
| | - Daithi S Heffernan
- Division of Surgical Research, Department of Surgery, Brown University, Rhode Island Hospital, Providence, RI, USA
| | - Alfred Ayala
- Division of Surgical Research, Department of Surgery, Brown University, Rhode Island Hospital, Providence, RI, USA
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Giri VP, Pandey S, Kumari M, Paswan SK, Tripathi A, Srivastava M, Rao CV, Katiyar R, Nautiyal CS, Mishra A. Biogenic silver nanoparticles as a more efficient contrivance for wound healing acceleration than common antiseptic medicine. FEMS Microbiol Lett 2020; 366:5580583. [PMID: 31580434 DOI: 10.1093/femsle/fnz201] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 10/02/2019] [Indexed: 12/13/2022] Open
Abstract
A simple and facile way of using biogenic silver nanoparticles (BSNP) (10-20 nm) was developed for wound healing acceleration and suppression of wound infections. The BSNP were formulated in an ointment base, and the study to accelerate the wound healing process was conducted in a rat. The pH of the BSNP ointment, pH 6.8 ± 0.5, lies in normal pH range of the human skin, with good spreadability and diffusibility. The wound closure rate, as a percentage, was highest at day 3 for a BSNP ointment-treated wound at 22.77 ± 1.60%, while in an untreated control the rate was 10.99 ± 1.74%, for Betadine 14.73 ± 2.36% and for Soframycin 18.55 ± 1.37%, compared with day 0. A similar pattern of wound closure rate was found at days 7 and 11. The antibacterial activity of BSNP was evaluated against wound-infection-causing bacteria Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli by the agar diffusion method. The total bacterial counts in the wound area were enumerated by the colony forming unit method. The lowest number of bacterial counts was found in the BSNP-treated wound compared with the other groups. BSNP treatment at 7.5% concentration enhanced migration of fibroblasts in a scratch assay. These findings reveal BSNP as an efficient contrivance for wound healing acceleration and as an eco-friendly alternative therapeutic antimicrobial agent.
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Affiliation(s)
- Ved Prakash Giri
- CSIR-Division of Microbial Technology, National Botanical Research Institute, Rana Pratap Marg, Lucknow, 226001, India.,Department of Botany, Lucknow University, Hasanganj, Lucknow 226007, India
| | - Shipra Pandey
- CSIR-Division of Microbial Technology, National Botanical Research Institute, Rana Pratap Marg, Lucknow, 226001, India.,Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Madhuree Kumari
- CSIR-Division of Microbial Technology, National Botanical Research Institute, Rana Pratap Marg, Lucknow, 226001, India.,Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Shravan Kumar Paswan
- CSIR-Division of Microbial Technology, National Botanical Research Institute, Rana Pratap Marg, Lucknow, 226001, India
| | - Ashutosh Tripathi
- CSIR-Division of Microbial Technology, National Botanical Research Institute, Rana Pratap Marg, Lucknow, 226001, India
| | - Manjoosha Srivastava
- CSIR-Division of Microbial Technology, National Botanical Research Institute, Rana Pratap Marg, Lucknow, 226001, India
| | - Chandana Venketswara Rao
- CSIR-Division of Microbial Technology, National Botanical Research Institute, Rana Pratap Marg, Lucknow, 226001, India
| | - Ratna Katiyar
- Department of Botany, Lucknow University, Hasanganj, Lucknow 226007, India
| | - Chandra Shekhar Nautiyal
- CSIR-Division of Microbial Technology, National Botanical Research Institute, Rana Pratap Marg, Lucknow, 226001, India
| | - Aradhana Mishra
- CSIR-Division of Microbial Technology, National Botanical Research Institute, Rana Pratap Marg, Lucknow, 226001, India.,Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
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Machado MP, Schavinski AZ, Deluque AL, Volpato GT, Campos KE. The Treatment of Prednisone in Mild Diabetic Rats: Biochemical Parameters and Cell Response. Endocr Metab Immune Disord Drug Targets 2020; 20:797-805. [DOI: 10.2174/1871530319666191204130007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 11/01/2019] [Accepted: 11/13/2019] [Indexed: 12/19/2022]
Abstract
Background:
Limited studies have been carried out with prednisone (PRED) in treatment by
glucose intolerant individuals, even in this model the animals presented low blood glucose levels at
adulthood, by the high regenerative capacity of β-cell.
Objective:
The aim was to evaluate the effects of the treatment of PRED in mild diabetes on biochemical
and immunological biomarkers.
Methods:
Rats were randomly divided into four groups: control (C), treated control C+PRED (treatment
of 1.25 mg/Kg/day PRED); diabetic DM (mild diabetes) and treated diabetic DM+PRED (treatment
with same dose as C+PRED group). Untreated groups received vehicle, adjusted volume to body
weight. The treatment lasted 21 days and measured body weight, food and water intake, and glycemia
weekly. In the 3rd week, the Oral Glucose Tolerance Test (OGTT) and the Insulin Tolerance Test (ITT)
was performed. On the last day, the rats were killed and the blood was collected for biochemical analyzes,
leukogram and immunoglobulin G levels.
Results:
There was a significant decrease in body weight in mild diabetes; however, the treatment in
diabetic groups increased food intake, glycemia, and the number of total leukocytes, lymphocytes and
neutrophils. On the other hand, it decreased the levels of triglycerides, high-density and very lowdensity
lipoproteins. In addition, diabetic groups showed glucose intolerance and mild insulin resistance,
confirming that this model induces glucose intolerant in adult life.
Conclusion:
The results showed that the use of prednisone is not recommended for glucose intolerant
individuals and should be replaced in order to not to aggravate this condition.
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Affiliation(s)
- Mariana P.R. Machado
- Postgraduate Program in Pharmacology and Biotechnology, São Paulo State University (UNESP), Institute of Biosciences, Botucatu, Sao Paulo, Brazil
| | - Aline Z. Schavinski
- Department of Physiology, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil
| | - Amanda L. Deluque
- Department of Physiology, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil
| | - Gustavo T. Volpato
- Laboratory of System Physiology and Reproductive Toxicology, Institute of Biological Sciences and Health, Federal University of Mato Grosso (UFMT), Barra do Garcas, Mato Grosso, Brazil
| | - Kleber E. Campos
- Laboratory of System Physiology and Reproductive Toxicology, Institute of Biological Sciences and Health, Federal University of Mato Grosso (UFMT), Barra do Garcas, Mato Grosso, Brazil
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