Abstract
Sepsis is a life-threatening entity caused by a multiorgan dysfunction that generates a dysregulated host response to infection and, after several processes, results in immunosuppression. Today, there are several sepsis management strategies to reduce its multisystemic effect and improve survival, but none of them have shown clear efficacy. Therefore, latest studies focus on clarifying and seeking therapeutic alternatives based on the analysis of the molecular pathophysiology of sepsis, in order to enter a late period of continuous immunosuppression also known as immunoparalysis.Apoptosis is a molecular and physiological mechanism, whose homeostasis is altered by the presence of sepsis. It causes the elimination of key cells of innate and adaptive immunity, which leads to an increased risk of—and often fatal— secondary infection. Several postmortem studies have confirmed that sepsis-induced immune cell apoptosis is a leading factor in the genesis of sepsis-related immunosuppression. It is believed that therapeutic strategies aimed at regulating apoptosis could improve survival. This review article describes the pathophysiological role of the apoptotic phenomenon in sepsis and its effect on the evolution of this entity
Highlights
a life-threatening entity caused by a multiorgan dysfunction
seeking therapeutic alternatives based on the analysis of the molecular pathophysiology
in order to enter a late period of continuous immunosuppression also known as immunoparalysis
Summary
Pablo Andrés Vélez* 1,d; Evelyn Castro 1,d; Mario Montalvo ; 3,a,c Santiago Aguayo 3,a; Gustavo Velarde 2,d; Fernando E. La sepsis es una entidad potencialmente mortal a causa de la disfunción multiorgánica que genera una respuesta alterada del huésped frente a la infección y que culmina, luego de varios procesos, en un estado de inmunosupresión. La apoptosis es un mecanismo molecular y fisiológico, cuya homeostasis es alterada en presencia de sepsis y que elimina células clave de la inmunidad innata y adaptativa, lo que conlleva a un mayor riesgo de infección secundaria, muchas veces fatal. Varios estudios post mortem han confirmado que la apoptosis de las células inmunes inducida por sepsis es un factor protagonista en la génesis de la inmunosupresión relacionada a la sepsis. Se cree que las estrategias terapéuticas dirigidas a regular la apoptosis podrían mejorar la supervivencia.
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