Cortisol Is an Associated-Risk Factor of Brain Dysfunction in Patients with Severe Sepsis and Septic Shock

Nguyen, Duc Nam; Huyghens, Luc; Zhang, Haibo; Schiettecatte, Johan; Smitz, Johan; Vincent, Jean‐Louis

doi:10.1155/2014/712742

Cited by 31 publications

(29 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Neither septic shock progression nor mortality rates (at 28 and 90 days, at ICU, and in hospital) differed between the two groups. An unexpected finding was that the hydrocortisone group had a lower frequency of delirium compared with the placebo group, which contradicts prior studies [60,61] , raising questions concerning the concept of cortisone-induced delirium in critically ill patients.…”

Section: Corticosteroidscontrasting

confidence: 59%

Update of Sepsis in the Intensive Care Unit

Genga¹,

Russell²

2017

J Innate Immun

114

View full text Add to dashboard Cite

Sepsis, the most common cause of admission to an intensive care unit (ICU), has had an increased incidence and prevalence over the last years with a simultaneous decrease in its short-term mortality. Sepsis survivors are more frequently discharged from hospital and often experience long-term outcomes such as late mortality, immune dysfunction, secondary infections, impaired quality of life, and unplanned readmissions. Early recognition and management of sepsis have challenged emergency care and critical care physicians and nurses. New sepsis definitions were produced and the Surviving Sepsis Campaign (SSC) 2016 was updated recently. Although hospital readmissions after sepsis are common, associated risk factors and how to manage patients who survive an episode of sepsis still need clarification. The immune dysfunction caused by sepsis/septic shock is complex, persistent, affects inflammatory and anti-inflammatory systems, and might be associated with long-term outcomes of sepsis. Several randomized controlled trials (RCT) that analyzed new (and old) interventions in sepsis/septic shock are discussed in this review in parallel with the SSC 2016 recommendations and other guidelines when relevant. RCTs addressing incidence, treatment, and prevention of important sepsis-associated organ dysfunction such as the acute respiratory distress syndrome, acute kidney injury, and brain dysfunction are highlighted. Finally, we briefly discuss the need for novel targets, predictive biomarkers, and new designs of RCTs in sepsis.

show abstract

Section: Corticosteroidscontrasting

confidence: 59%

Update of Sepsis in the Intensive Care Unit

Genga¹,

Russell²

2017

J Innate Immun

114

View full text Add to dashboard Cite

show abstract

“…The association between HPA-axis dysfunction and depression is suggested by the fact that many depressed patients exhibit cortisol hypersecretion [21] and impaired glucocorticoid negative feedback system [22]. In addition, exposure to high cortisol levels might be injurious to the brain, especially in the hippocampus or frontal cortex, which have a high concentration of glucocorticoid receptors [23]. Given that depressed patients have been reported to have a smaller hippocampal volume compared with healthy controls [24], the hippocampal volume predicts antidepressant efficacy in depressed patients [25].…”

Section: Discussionmentioning

confidence: 99%

Administration of Asian Herb Bennet (Geum japonicum) Extract Reverses Depressive-Like Behaviors in Mouse Model of Depression Induced by Corticosterone

Lim

Han

et al. 2019

Nutrients

View full text Add to dashboard Cite

Geum japonicum, commonly known as Asian herb bennet, has been used as a diuretic, astringent, anti-dizziness, and anti-headache agent in traditional medicine. Since the antidepressant-like effects of G. japonicum extract have not been well studied, we examined the antidepressant-like effects of G. japonicum extract using depressive-like behavior induced in mice through daily injection of corticosterone (CORT). ICR mice (male, 8 weeks old) were treated with CORT (40 mg/kg, i.p.) and orally administered using oral gavage needles with G. japonicum extract (30, 100, and 300 mg/kg) for 4 weeks. Behavioral experiments were performed 1 h after administration. The control mice exhibited a significant increase in the immobility times in the tail suspension and forced swim tests as well as the step-through latency time in the passive avoidance test. Further, the control group showed a significant decrease in their sucrose consumption. However, treatment with G. japonicum extract at doses of 100 and 300 mg/kg significantly improved these depression-like behaviors without altering the locomotor activity. Moreover, treatment with G. japonicum extract significantly prevented the decrease in the expression of brain-derived neurotrophic factor (BDNF) in the hippocampus. In addition, G. japonicum extract had neuroprotective effects against CORT-induced neurotoxicity in SH-SY5Y cells. Our study indicates that G. japonicum extract exhibits antidepressant-like activity in CORT-induced depressive mice, which might be as a result of increased BDNF expression.

show abstract

“…15,[105][106][107][108][109] In fact, the use of exogenous steroids has been associated with the development of various neuropsychiatric disorders, including delirium, depression, mania, psychosis, and cognitive/memory impairment in up to 60% of those taking corticosteroids. 110 In older adults, systemic GC use may be a contributor to cognitive dysfunction 111 and delirium. 112,113…”

Section: Glucocorticoids: Neuroendocrine Hypothesismentioning

confidence: 99%