Wang Yu, Wang Weixue, Zhang Yi, Fleishman Joshua S, Wang Hongquan
Department of Geriatrics, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, 100049, China.
Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, 11439, USA.
Eur J Med Chem. 2025 Feb 5;283:117152. doi: 10.1016/j.ejmech.2024.117152. Epub 2024 Dec 8.
Sepsis-associated acute lung injury (SALI) is a common complication of sepsis, consisting of a dysfunctional host response to infection-mediated heterogenous complexes. SALI is reported in up to 50 % of patients with sepsis and causes poor outcomes. Despite high incidence, there is a lack of understanding in its pathogenesis and optimal treatment. A better understanding of the molecular mechanisms underlying SALI may help produce better therapeutics. The effects of altered cell-death mechanisms, such as non-apoptotic regulated cell death (RCD) (i.e., ferroptosis), on the development of SALI are beginning to be discovered, while targeting ferroptosis as a meaningful target in SALI is increasingly being recognized. Here, we outline how a susceptible lung alveoli may develop SALI. Then we discuss the general mechanisms underlying ferroptosis, and how it contributes to SALI. We then outline the chemical structures of the emerging agents or compounds that can protect against SALI by inhibiting ferroptosis, summarizing their potential pharmacological effects. Finally, we highlight key limitations and possible strategies to overcome them. This review suggests that a detailed mechanistic and biological understanding of ferroptosis can foster the development of pharmacological antagonists in the treatment of SALI.
脓毒症相关急性肺损伤(SALI)是脓毒症的常见并发症,由宿主对感染介导的异质复合物的功能失调反应组成。据报道,高达50%的脓毒症患者会出现SALI,且预后不良。尽管发病率很高,但对其发病机制和最佳治疗方法仍缺乏了解。更好地理解SALI潜在的分子机制可能有助于开发出更好的治疗方法。细胞死亡机制改变的影响,如非凋亡性调节性细胞死亡(RCD)(即铁死亡),对SALI发生发展的影响正开始被发现,同时将铁死亡作为SALI中有意义的靶点越来越受到认可。在此,我们概述了易感性肺泡如何发展为SALI。然后我们讨论铁死亡的一般机制,以及它如何导致SALI。接着我们概述了可通过抑制铁死亡来预防SALI的新型药物或化合物的化学结构,总结它们潜在的药理作用。最后,我们强调关键局限性以及克服这些局限性的可能策略。本综述表明,对铁死亡进行详细的机制和生物学理解可促进治疗SALI的药理拮抗剂的开发。
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