Sieminski Mariusz, Szaruta-Raflesz Karolina, Szypenbejl Jacek, Krzyzaniak Klaudia
Department of Emergency Medicine, Medical University of Gdansk, 80-214 Gdansk, Poland.
Antioxidants (Basel). 2023 Sep 21;12(9):1786. doi: 10.3390/antiox12091786.
Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. The brain is one of the organs involved in sepsis, and sepsis-induced brain injury manifests as sepsis-associated encephalopathy (SAE). SAE may be present in up to 70% of septic patients. SAE has a very wide spectrum of clinical symptoms, ranging from mild behavioral changes through cognitive disorders to disorders of consciousness and coma. The presence of SAE increases mortality in the population of septic patients and may lead to chronic cognitive dysfunction in sepsis survivors. Therefore, therapeutic interventions with neuroprotective effects in sepsis are needed. Melatonin, a neurohormone responsible for the control of circadian rhythms, exerts many beneficial physiological effects. Its anti-inflammatory and antioxidant properties are well described. It is considered a potential therapeutic factor in sepsis, with positive results from studies on animal models and with encouraging results from the first human clinical trials. With its antioxidant and anti-inflammatory potential, it may also exert a neuroprotective effect in sepsis-associated encephalopathy. The review presents data on melatonin as a potential drug in SAE in the wider context of the pathophysiology of SAE and the specific actions of the pineal neurohormone.
脓毒症被定义为由宿主对感染的失调反应引起的危及生命的器官功能障碍。大脑是参与脓毒症的器官之一，脓毒症诱导的脑损伤表现为脓毒症相关性脑病（SAE）。SAE在高达70%的脓毒症患者中可能存在。SAE具有非常广泛的临床症状，从轻微的行为改变到认知障碍，再到意识障碍和昏迷。SAE的存在会增加脓毒症患者群体的死亡率，并可能导致脓毒症幸存者出现慢性认知功能障碍。因此，需要在脓毒症中采取具有神经保护作用的治疗干预措施。褪黑素是一种负责控制昼夜节律的神经激素，具有许多有益的生理作用。其抗炎和抗氧化特性已得到充分描述。它被认为是脓毒症的一种潜在治疗因素，在动物模型研究中取得了阳性结果，并且在首次人体临床试验中也取得了令人鼓舞的结果。凭借其抗氧化和抗炎潜力，它也可能在脓毒症相关性脑病中发挥神经保护作用。这篇综述在SAE病理生理学的更广泛背景以及松果体神经激素的具体作用方面，介绍了褪黑素作为SAE潜在药物的数据。
