Programa de Pós-graduação em Patologia, Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA, Porto Alegre, RS, 90050-170, Brazil.
Laboratório de Biofísica Celular e Inflamação, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS, Porto Alegre, Brazil.
Mol Neurobiol. 2021 Jun;58(6):2770-2779. doi: 10.1007/s12035-021-02303-2. Epub 2021 Jan 26.
Sepsis is an organ dysfunction caused by an uncontrolled inflammatory response from the host to an infection. Sepsis is the main cause of morbidity and mortality in intensive care units (ICU) worldwide. One of the first organs to suffer from injuries resulting from sepsis is the brain. The central nervous system (CNS) is particularly vulnerable to damage, mediated by inflammatory and oxidative processes, which can cause the sepsis-associated encephalopathy (SAE), being reported in up to 70% of septic patients. This review aims to bring a summary of the main pathophysiological changes and dysfunctions in SAE, and the main focuses of current experimental studies for new treatments and therapies. The pathophysiology of SAE is complex and multifactorial, combining intertwined processes, and is promoted by countless alterations and dysfunctions resulting from sepsis, such as inflammation, neuroinflammation, oxidative stress, reduced brain metabolism, and injuries to the integrity of the blood-brain barrier (BBB). The treatment is limited once its cause is not completely understood. The patient's sedation is far to provide an adequate treatment to this complex condition. Studies and experimental advances are important for a better understanding of its pathophysiology and for the development of new treatments, medicines, and therapies for the treatment of SAE and to reduce its effects during and after sepsis.
脓毒症是宿主对感染的失控性炎症反应引起的器官功能障碍。脓毒症是全球重症监护病房（ICU）发病率和死亡率的主要原因。首先受到脓毒症引起的损伤的器官之一是大脑。中枢神经系统（CNS）特别容易受到炎症和氧化过程的损害，这可能导致脓毒症相关性脑病（SAE），在多达 70%的脓毒症患者中报告。这篇综述旨在总结 SAE 的主要病理生理变化和功能障碍，以及当前用于新治疗方法和疗法的实验研究的主要关注点。SAE 的病理生理学是复杂的和多因素的，结合了相互交织的过程，并由脓毒症引起的无数改变和功能障碍促进，如炎症、神经炎症、氧化应激、脑代谢减少以及血脑屏障（BBB）完整性受损。由于不完全了解其病因，治疗受到限制。对患者进行镇静远不能为这种复杂情况提供足够的治疗。研究和实验进展对于更好地理解其病理生理学以及开发新的治疗方法、药物和疗法来治疗 SAE 并减少其在脓毒症期间和之后的影响非常重要。
