Centre for Heart Lung Innovation.
Department of Experimental Medicine Program.
Curr Opin Lipidol. 2019 Apr;30(2):108-116. doi: 10.1097/MOL.0000000000000577.
Sepsis is a common syndrome of multiorgan system dysfunction caused by a dysregulated inflammatory response to an infection and is associated with high rates of mortality. Plasma lipid and lipoprotein levels and composition change profoundly during sepsis and have emerged as both biomarkers and potential therapeutic targets for this condition. The purpose of this article is to review recent progress in the understanding of the molecular regulation of lipid metabolism during sepsis.
Patients who experience greater declines in high-density lipoprotein during sepsis are at much greater risk of succumbing to organ failure and death. Although the causality of these findings remains unclear, all lipoprotein classes can sequester and prevent the excessive inflammation caused by pathogen-associated lipids during severe infections such as sepsis. This primordial innate immune function has been best characterized for high-density lipoproteins. Most importantly, results from human genetics and preclinical animal studies have suggested that several lipid treatment strategies, initially designed for atherosclerosis, may hold promise as therapies for sepsis.
Lipid and lipoprotein metabolism undergoes significant changes during sepsis. An improved understanding of the molecular regulation of these changes may lead to new opportunities for the treatment of sepsis.
脓毒症是一种由感染引起的全身多器官功能障碍综合征，其特征是炎症反应失调，死亡率较高。脓毒症期间，血浆脂质和脂蛋白水平及组成发生显著变化，已成为该疾病的生物标志物和潜在治疗靶点。本文旨在综述脓毒症期间脂质代谢分子调控的最新进展。
脓毒症患者的高密度脂蛋白（HDL）水平下降幅度越大，发生器官衰竭和死亡的风险就越高。尽管这些发现的因果关系尚不清楚，但所有脂蛋白类都可以隔离和阻止严重感染（如脓毒症）中病原体相关脂质引起的过度炎症。高密度脂蛋白（HDL）对这种原始先天免疫功能的特征描述最好。最重要的是，来自人类遗传学和临床前动物研究的结果表明，最初为动脉粥样硬化设计的几种脂质治疗策略可能有望成为脓毒症的治疗方法。
脓毒症期间脂质和脂蛋白代谢发生显著变化。深入了解这些变化的分子调控机制可能为脓毒症的治疗带来新的机会。
