Cellular energetic metabolism in sepsis:: The need for a systems approach
Cellular energetic metabolism in sepsis:: The need for a systems approach
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DOI：
10.1016/j.bbabio.2008.04.024
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发表时间：
2008-07-01
影响因子：
4.3
通讯作者：
Singer, Mervyn
中科院分区：
文献类型：
--
作者：
Carre, Jane E.;Singer, Mervyn
脓毒症是一种复杂的病理生理紊乱，由全身炎症反应引起。根据出现的炎症症状、多器官衰竭(MOF)或器官衰竭合并低血压(感染性休克)对患者进行临床分类。发生在MOF中的器官损害不是病原体本身的直接影响，而是患者的CLI调节的炎症反应。尽管MOF的机制还不完全清楚，但细胞能量代谢的紊乱越来越多地被认为是相关的。在这篇综述中，我们描述了脓毒症中影响细胞ATP供需的各种因素是如何改变的，以及这些因素是如何随着时间的推移而变化的。我们将强调需要一种综合系统办法，以确定这些因素在不同器官衰竭和恢复过程中的相对重要性。提出了一个模块化的框架，可以用来评估在这种复杂的病理生理条件下细胞能量学的控制层次。(C)2008爱思唯尔B.V.保留所有权利。
Sepsis is a complex pathophysiological disorder arising from a systemic inflammatory response to infection. Patients are clinically classified according to the presence of signs of inflammation alone, multiple organ failure (MOF), or organ failure plus hypotension (septic shock). The organ damage that occurs in MOF is not a direct effect of the pathogen itself, but rather of the clysregulated inflammatory response of the patient. Although mechanisms underlying MOF are not completely understood, a disruption in cellular energetic metabolism is increasingly implicated. In this review, we describe how various factors affecting cellular ATP supply and demand appear to be altered in sepsis, and how these vary through the timecourse. We will emphasise the need for an integrated systems approach to determine the relative importance of these factors in both the failure and recovery of different organs. A modular framework is proposed that can be used to assess the control hierarchy of cellular energetics in this complex pathophysiological condition. (c) 2008 Elsevier B.V. All rights reserved.