Die zelluläre Basis des Organversagens bei Sepsis – Signalwege in Gewebeschädigung und Reparaturprozessen

Abstract

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Sublingual microcirculation and internal environment changes as early indications of sepsis: A prospective observational study

“…This is an important cause of organ dysfunction, but not a determining factor, since the severity of organ dysfunction is determined by several factors, including injury, repair, and compensation. 34 Fourthly, the relevant laboratory indicators of an organ injury are continuous variables, which are artificially scored and summarized into SOFA scores. This leads to insensitivity to minor organ damage that has not yet reached the level that causes changes in the SOFA score.…”

“…Meanwhile, the parameters of sublingual microcirculation did not improve in the two groups, even in the non‐sepsis group. This may be related to the continuous damage and repair caused by the failure of removal of the infection in a short time, 30 which may explain the slow recovery of microcirculation parameters. Therefore, it may take longer to observe the recovery of sublingual microcirculation disorder caused by infection.…”

“…Thirdly, the infection‐induced disruption of continuous microcirculation disorder can result in the disruption of tissue aerobic metabolism and internal environment. This is an important cause of organ dysfunction, but not a determining factor, since the severity of organ dysfunction is determined by several factors, including injury, repair, and compensation 34 . Fourthly, the relevant laboratory indicators of an organ injury are continuous variables, which are artificially scored and summarized into SOFA scores.…”

The leukocyte non-coding RNA landscape in critically ill patients with sepsis

“…The host response during infection is characterized by a balance between resistance (seeking to limit the pathogen load) and tolerance (aiming to retain cell and organ functions) ( Schneider and Ayres, 2008 ). In sepsis both mechanisms can become uncontrolled, wherein aberrant activation of resistance pathways results in tissue damage and inadequate tolerance can cause immune suppression with enhanced susceptibility to secondary infections ( Bauer and Wetzker, 2020 ). While our time-sequential data in healthy humans injected with LPS suggest that coding and long non-coding RNA profiles in blood leukocytes of sepsis patients particularly reflect a tolerant state, time course studies in patients are needed to increase the insight into the role of distinct RNA species in the interplay between resistance and tolerance.…”

The Role of Microbiota in Neutrophil Regulation and Adaptation in Newborns

“…Akin to BCG vaccinations, infants born to mothers with hepatitis B infection are prone to develop trained immunity in neutrophils or other haematopoietic phagocytic cells such as dendritic cells (DCs) ( 114 ). Yet, inappropriate induction of these opposing reactions (training vs. tolerance), might provoke maladaptive responses such as hyper-inflammation exhibiting a close relationship to overflowing resistance responses (trained immunity), or increased susceptibility to opportunistic infections (tolerance) ( 71 , 115 – 117 ).…”