The role of hormones in sepsis: an integrated overview with a focus on mitochondrial and immune cell dysfunction

Abstract

Sepsis is a dysregulated host response to infection that results in life-threatening organ dysfunction. Virtually every body system can be affected by this syndrome to greater or lesser extents. Gene transcription and downstream pathways are either up- or downregulated, albeit with considerable fluctuation over the course of the patient’s illness. This multi-system complexity contributes to a pathophysiology that remains to be fully elucidated. Consequentially, little progress has been made to date in developing new outcome-improving therapeutics. Endocrine alterations are well characterised in sepsis with variations in circulating blood levels and/or receptor resistance. However, little attention has been paid to an integrated view of how these hormonal changes impact upon the development of organ dysfunction and recovery. Here, we present a narrative review describing the impact of the altered endocrine system on mitochondrial dysfunction and immune suppression, two interlinked and key aspects of sepsis pathophysiology.

Relation of Plasma Catecholamine Concentrations and Myocardial Mitochondrial Respiratory Activity in Anesthetized and Mechanically Ventilated, Cardiovascular Healthy Swine

“…Results depended on whether chal-lenges were acute [19,23] or maintained over days and weeks [18,52,53] and/or whether exogenous catecholamine administration [18,19] had been studied. Acute increases in plasma catecholamine levels are normally associated with increased mitochondrial respiratory enzyme activity, and, hence, OxPhos and/or ETC [54], e.g., during physical exercise [55]. Our data suggest that even variations in the plasma catecholamine concentrations within the normal physiological range may affect the cardiac tissue β 2 -adrenergic receptor expression and, thereby possibly the response to β-adrenoceptor agonists.…”

Effect of cortisol and glycosylated-hemoglobin levels on mortality in intensive care unit

“…Sepsis, trauma, burns, and any other acute illness are perceived as stress because they threaten the body’s normal homeostatic processes. 5 As a protective response to stress, the adrenal cortex secretes cortisol in amounts up to 20 times higher than usual. 6 It has been argued that cortisol levels rise in correlation with the severity of acute stress.…”

The role of platelets in sepsis: A review

“…However, aberrations in this response occur during sepsis, leading to an imbalance. However, the significance of the endocrine system as a pivotal determinant of organ dysfunction and immunosuppression in sepsis has been largely disregarded [ 114 ]. During the early stages of sepsis, the levels of cortisol, catecholamines, and other substances are elevated in response to severe stress.…”