Intermediarios del ciclo de Krebs en sepsis: una revisión sistemática

Abstract

IntroductionThe continued functioning of the tricarboxylic acids cycle (TAC) in shock states has been documented. Along with the ‘fragmentation’ of their enzymatic reactions in cellular models of hypoxia this enables the catabolic reactions to continue to take place. ObjectiveTo identify studies that quantified TAC intermediaries in animal models of sepsis and in septic patients.Data sources: Electronic search in PubMed, Embase, Cochrane and LILACS and manual review of bibliography of articles included, until December 2018.Selection criteria: A study in which TAC intermediaries were measured at the tissue or blood level in septic patients or animal models of sepsis. ResultsA total of 2,478 articles were identified, of which 10 were included. Five were performed in animal models. The intermediaries were evaluated at different times of evolution and in different tissues, finding increased, normal and decreased concentrations. The remaining 5 were in humans, and measured blood metabolites. In 4 of them, there was an increase in the concentrations of intermediaries in non-surviving patients and in those with a worse prognosis. In 3 decreases in concentrations were reported in survivors or in patients with a decrease in the severity of organic dysfunction. ConclusionsFew articles were identified to evaluate CAT metabolites. The results indicate different changes in the concentrations of these intermediates at tissue and blood levels, which may correspond to the organ-specific metabolic response observed in sepsis and to the temporal and dynamic behaviour of metabolism during the different phases of sepsis.