Harmful molecular mechanisms in sepsis
Daniel Rittirsch, Michael A. Flierl, Peter A. Ward2008Nature reviews. Immunology
CardiovascularEndocrine (ADH/ACTH/MSH)GastrointestinalHematologicalHypothalamic-PituitaryImmune/InnateMusculoskeletalNeurologicalRespiratory/Sinus
Bacterial EndotoxinsIndoor Mold (Stachybotrys, Aspergillus, etc.)Water-Damaged Buildings (WDB)
Abstract
Sepsis and sepsis-associated multi-organ failure are major challenges for scientists and clinicians and are a tremendous burden for health-care systems. Despite extensive basic research and clinical studies, the pathophysiology of sepsis is still poorly understood. We are now beginning to understand that sepsis is a heterogeneous, dynamic syndrome caused by imbalances in the 'inflammatory network'. In this Review, we highlight recent insights into the molecular interactions that occur during sepsis and attempt to unravel the nature of the dysregulated immune response during sepsis.
Key Biomarkers
ACLAACTH/cortisolADH/osmolalityAGAC4aGlutamate/Glutamine ratioHLA DR haplotypesLactateMMP9MSHTGF beta-1VEGFVIPvWF
Symptom Clusters
Capillary hypoperfusionCognitive dysfunctionEpistaxisHemoptysisMulti-system, multi-symptom presentationNeurologic symptomsVisual contrast sensitivity deficits
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