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脓毒症性心肌病中线粒体功能障碍的潜在机制。

The potential mechanism of mitochondrial dysfunction in septic cardiomyopathy.

作者信息

Pan Pan, Wang Xiaoting, Liu Dawei

机构信息

Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.

出版信息

J Int Med Res. 2018 Jun;46(6):2157-2169. doi: 10.1177/0300060518765896. Epub 2018 Apr 11.

Abstract

Septic cardiomyopathy is one of the most serious complications of sepsis or septic shock. Basic and clinical research has studied the mechanism of cardiac dysfunction for more than five decades. It has become clear that myocardial depression is not related to hypoperfusion. As the heart is highly dependent on abundant adenosine triphosphate (ATP) levels to maintain its contraction and diastolic function, impaired mitochondrial function is lethally detrimental to the heart. Research has shown that mitochondria play an important role in organ damage during sepsis. The mitochondria-related mechanisms in septic cardiomyopathy have been discussed in terms of restoring mitochondrial function. Mitochondrial uncoupling proteins located in the mitochondrial inner membrane can promote proton leakage across the mitochondrial inner membrane. Recent studies have demonstrated that proton leakage is the essential regulator of mitochondrial membrane potential and the generation of reactive oxygen species (ROS) and ATP. Other mechanisms involved in septic cardiomyopathy include mitochondrial ROS production and oxidative stress, mitochondria Ca handling, mitochondrial DNA in sepsis, mitochondrial fission and fusion, mitochondrial biogenesis, mitochondrial gene regulation and mitochondria autophagy. This review will provide an overview of recent insights into the factors contributing to septic cardiomyopathy.

摘要

脓毒症性心肌病是脓毒症或脓毒性休克最严重的并发症之一。基础和临床研究对心脏功能障碍的机制进行了五十多年的研究。现已明确,心肌抑制与灌注不足无关。由于心脏高度依赖充足的三磷酸腺苷(ATP)水平来维持其收缩和舒张功能,线粒体功能受损对心脏具有致命的危害。研究表明,线粒体在脓毒症期间的器官损伤中起重要作用。脓毒症性心肌病中线粒体相关机制已从恢复线粒体功能方面进行了探讨。位于线粒体内膜的线粒体解偶联蛋白可促进质子跨线粒体内膜泄漏。最近的研究表明,质子泄漏是线粒体膜电位以及活性氧(ROS)和ATP生成的关键调节因子。脓毒症性心肌病涉及的其他机制包括线粒体ROS生成和氧化应激、线粒体钙处理、脓毒症中的线粒体DNA、线粒体裂变和融合、线粒体生物发生、线粒体基因调控和线粒体自噬。本综述将概述近期对导致脓毒症性心肌病的因素的见解。

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