Pathomechanismen des Organversagens

Abstract

Proinflammatory mediators as well as increased formation of reactive oxygen and nitrogen species impair cellular respiration during sepsis. In particular, the highly reactive peroxynitrite irreversibly damages lipids, proteins and nucleic acids and also inhibits enzyme complexes of the respiratory chain. In this way cellular metabolic functions and subsequently organ functions are also impaired. Repair of DNA by poly(ADP-ribose)polymerase consumes large amounts of nicotinamide adenine dinucleotide (NAD+) which leads to cellular NAD+ depletion further promoting inflammation. This article summarizes central aspects of the pathophysiology of mitochondrial dysfunction during sepsis and gives an overview about newly developed strategies which proved effective in experimental studies and may have a potential clinical application in the future.

The mechanism of multiple organ dysfunction syndrome in patients with COVID‐19

“…ROS include superoxide radicals (•O 2 − ), hydrogen peroxide (H 2 O 2 ), hydroxyl radicals (•OH), and singlet oxygen (1O 2 ), which are closely associated with multiple physiological activities, such as protein phosphorylation, activation of several transcription factors, apoptosis, immunity, and differentiation 11 . The increase of ROS will irreversibly destroy proteins, lipids, and nucleic acids, inhibit the enzyme complex of the respiratory chain and cause mitochondrial dysfunction, leading to cell damage, and further organ dysfunction 12 . Oxidative stress may be a contributing factor in the pathogenesis of MODS due to the association of elevated plasma levels of ROS, NO, and ONOO − with MODS 13 .…”

Reduction of oxidative stress response and protection of liver and renal cell functions by reduced glutathione in lower limb arterial ischemia–reperfusion in New Zealand white rabbits with high triglyceride levels

“…IR has been associated with multi-organ failure in the heart, lungs, liver, gastrointestinal tract, nervous system, and kidneys, as well as an increase in ROS in the plasma post-IR [ 34 , 35 ]. A large amount of ROS is generated and reaches the target organs via blood circulation, where it breaks the antioxidant defence capacity, thereby eliciting oxidative distress in the target organ [ 36 ].…”

Die Niere in der Sepsis

“…Laut einer neueren Untersuchung von Oppert et al [1] [3]. Nicht zu vergessen sind aber auch me dikamententoxische Effekte, die beispiels weise durch antimikrobielle Medikamente oder kolloidale Volumenersatzmittel aus gelöst werden können.…”