Ismail Hassan Fatima, Didari Tina, Khan Fazlullah, Niaz Kamal, Mojtahedzadeh Mojtaba, Abdollahi Mohammad
The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran.
Department of Toxicology and Pharmacology, Tehran University of Medical Sciences, Tehran, Iran.
Cell J. 2020 Jan;21(4):363-370. doi: 10.22074/cellj.2020.6286. Epub 2019 Jul 29.
Despite advances in sepsis management, it remains a major intensive-care-unit (ICU) concern. From new prospective, positive effects of metformin, such as anti-oxidant and anti-inflammatory properties are considered potentially beneficial properties for management of septic patients. This article reviewed the potential ameliorative effects of metformin in sepsis-induced organ failure. Information were retrieved from PubMed, Scopus, Embase, and Google Scholar. Multi-organ damage, oxidative stress, inflammatory cytokine stimulation, and altered circulation are hallmarks of sepsis. Metformin exerts its effect via adenosine monophosphate-activated protein kinase (AMPK) activation. It improves sepsis-induced organ failure by inhibiting the production of reactive oxygen species (ROS) and pro-inflammatory cytokines, preventing the activation of transcription factors related to inflammation, decreasing neutrophil accumulation/infiltration, and also maintaining mitochondrial membrane potential. Studies reported the safety of metformin therapeutic doses, with no evidence of lactic acidosis, in septic patients.
尽管脓毒症管理取得了进展，但它仍然是重症监护病房（ICU）关注的主要问题。从新的角度来看，二甲双胍的积极作用，如抗氧化和抗炎特性，被认为对脓毒症患者的管理具有潜在的有益特性。本文综述了二甲双胍对脓毒症诱导的器官衰竭的潜在改善作用。信息从PubMed、Scopus、Embase和谷歌学术中检索。多器官损伤、氧化应激、炎性细胞因子刺激和循环改变是脓毒症的特征。二甲双胍通过激活单磷酸腺苷激活的蛋白激酶（AMPK）发挥作用。它通过抑制活性氧（ROS）和促炎细胞因子的产生、防止与炎症相关的转录因子激活、减少中性粒细胞积累/浸润以及维持线粒体膜电位来改善脓毒症诱导的器官衰竭。研究报道了二甲双胍治疗剂量在脓毒症患者中的安全性，没有乳酸酸中毒的证据。
