Wu Jie, Zhang Weijin, Zhao Shucan, Lin Jianqun, Hu Shijian, Mao Liangfeng, An Sheng
Department of Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China.
Department of Internal Medicine General Ward, Shantou Central Hospital, Shantou 515000, Guangdong, China. Corresponding author: Zhang Weijin, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2021 Jun;33(6):765-768. doi: 10.3760/cma.j.cn121430-20210127-00133.
Sepsis is a critical illness with high morbidity and mortality. Anaerobic glycolysis plays an important role in the pathogenesis of sepsis. Pyruvate dehydrogenase complex (PDHC) serves as a key regulator during sepsis. With PDHC dephosphorylation and deacetylation, PDHC activity is upregulated, allowing pyruvate translocate to mitochondria in aerobic condition, preceding the production of acetyl-CoA to accelerate aerobic oxidation. Activation of PDHC improves the prognosis of sepsis through regulating the balance of lactate, release of inflammatory factors and energy metabolism. A variety of remedies can improve the prognosis of patients with sepsis by up-regulating the activity of PDHC, including dichloroacetate (DCA), vitamin B1, milrinone, tumor necrosis factor binding protein, and ciprofloxacin.This article reviews the role and the regulatory mechanism of PDHC and signal pathway in the sepsis metabolism, in order to innovate treatment for sepsis and multiple organ dysfunction.
脓毒症是一种发病率和死亡率都很高的危重病。无氧糖酵解在脓毒症的发病机制中起重要作用。丙酮酸脱氢酶复合体（PDHC）在脓毒症期间作为关键调节因子。随着PDHC去磷酸化和去乙酰化，PDHC活性上调，使丙酮酸在有氧条件下转运至线粒体，先于乙酰辅酶A的产生以加速有氧氧化。PDHC的激活通过调节乳酸平衡、炎症因子释放和能量代谢来改善脓毒症的预后。多种药物可通过上调PDHC活性来改善脓毒症患者的预后，包括二氯乙酸（DCA）、维生素B1、米力农、肿瘤坏死因子结合蛋白和环丙沙星。本文综述了PDHC在脓毒症代谢中的作用、调节机制及信号通路，以期为脓毒症及多器官功能障碍的治疗带来创新。
