The Metabolomics of Critical Illness.
The Metabolomics of Critical Illness.
复制标题
危重疾病的代谢组学。
DOI：
10.1007/164_2022_622
复制
发表时间：
2023
影响因子：
--
通讯作者：
Rogers,AngelaJ
中科院分区：
文献类型：
--
作者：
Pacheco-Navarro,AnaE;Rogers,AngelaJ
危重病与免疫、内分泌和肾上腺素能介质驱动的代谢的显著变化相关。这些变化涉及分解代谢过程的早期激活，导致能量底物可用性增加;随后，它们随后是以线粒体功能紊乱为特征的低代谢阶段。在脓毒症和ARDS中，这些快速的临床变化反映在血浆和其他液体的代谢组学谱中，这表明代谢组学有一天可以用于辅助这些综合征的诊断和鉴定。一些代谢物，如乳酸盐，已经在临床上使用，并定义患者感染性休克，一种高死亡率的败血症亚型。更大规模的代谢组学分析可能最终提供一种工具来识别可能对治疗有反应的重症患者亚组，但在这种类型的精准医学易于在临床环境中使用之前，还需要进一步的工作。
Critical illness is associated with dramatic changes in metabolism driven by immune, endocrine, and adrenergic mediators. These changes involve early activation of catabolic processes leading to increased energetic substrate availability; later on, they are followed by a hypometabolic phase characterized by deranged mitochondrial function. In sepsis and ARDS, these rapid clinical changes are reflected in metabolomic profiles of plasma and other fluids, suggesting that metabolomics could one day be used to assist in the diagnosis and prognostication of these syndromes. Some metabolites, such as lactate, are already in clinical use and define patients with septic shock, a high-mortality subtype of sepsis. Larger-scale metabolomic profiling may ultimately offer a tool to identify subgroups of critically ill patients who may respond to therapy, but further work is needed before this type of precision medicine is readily employed in the clinical setting.