Negovsky Scientific Research Institute of General Reanimatology, Moscow, 107031, Russia.
Biochemistry (Mosc). 2021 May;86(5):563-567. doi: 10.1134/S0006297921050059.
Sepsis is one of the most serious problems in modern medicine. Long-term outcomes in septic shock patients are very discouraging: 75% individuals who survived sepsis and septic shock demonstrate signs of organ failure and experience persistent functional deficit. Acute sepsis and its management in an intensive care unit (ICU) to a great extent determine the pathogenesis of further complications. We believe that the concept of phenoptosis proposed by Prof. Skulachev deserves a special attention from anesthesiologists and ICU doctors. According to this concept, septic shock is a suicidal mechanism of programmed organism death, which protects human population from dangerously infected individuals. The article suggests a potential approach to the sepsis treatment based on the notion that septic shock can be prevented by identification and blockade of receptors involved in the processing of phenoptotic signal induced by lipopolysaccharide and other substances that initiate septic shock. In view of this, the search for agents that can block molecular mechanisms of the phenoptotic signal transmission seems very promising.
脓毒症是现代医学中最严重的问题之一。脓毒性休克患者的长期预后非常令人沮丧：75%的存活患者表现出器官衰竭的迹象，并经历持续的功能缺陷。急性脓毒症及其在重症监护病房（ICU）的治疗在很大程度上决定了进一步并发症的发病机制。我们认为，斯库拉切夫教授提出的“细胞凋亡”概念值得麻醉师和 ICU 医生特别关注。根据这一概念，脓毒性休克是一种程序性生物死亡的自杀机制，它可以保护人类免受受感染个体的威胁。本文提出了一种基于这样一种观点的脓毒症治疗方法，即通过鉴定和阻断参与由脂多糖和其他引发脓毒性休克的物质诱导的细胞凋亡信号处理的受体，可以预防脓毒性休克。鉴于此，寻找能够阻断细胞凋亡信号转导的分子机制的药物似乎非常有前景。
