Document Detail


Mitochondrial Dysfunction in Sepsis.
MedLine Citation:
PMID:  13678565     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Sepsis is an increasingly common problem, particularly among critically ill patients. Mechanisms by which sepsis induces organ dysfunction have not been elucidated. The coexisting findings (unique to sepsis) of metabolic acidosis yet increased tissue oxygen tensions suggest cellular availability but decreased use of oxygen (tissue dysoxia). Because mitochondria use more than 90% of total body oxygen consumption for adenosine triphosphate (ATP) generation, a bioenergetic abnormality is implied. Cell and animal data have shown that nitric oxide (and its metabolites), produced in considerable excess in patients with sepsis, can affect oxidative phosphorylation by inhibiting several of its component respiratory enzymes. Human data are scarce. However, in skeletal muscle biopsies taken from patients with sepsis, we have recently demonstrated a relationship between increased nitric oxide production, antioxidant depletion, reduced respiratory chain complex I activity, and low ATP levels. These findings correlated with severity of disease and outcome and support the notion that mitochondrial dysfunction resulting in bioenergetic failure may be an important factor in the pathophysiology of sepsis-associated multiorgan failure. However, a reasonable argument can be made that the reduction in energy supply could represent a last-ditch adaptive response to ongoing inflammation, resulting in a cellular shutdown analogous to hibernation that allows eventual restoration of organ function and long-term survival in patients fit enough to survive the acute phase.
Authors:
David Brealey; Mervyn Singer
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Current infectious disease reports     Volume:  5     ISSN:  1534-3146     ISO Abbreviation:  Curr Infect Dis Rep     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-Sep-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888983     Medline TA:  Curr Infect Dis Rep     Country:  -    
Other Details:
Languages:  ENG     Pagination:  365-371     Citation Subset:  -    
Affiliation:
Bloomsbury Institute of Intensive Care Medicine, Wolfson Institute of Biomedical Research, University College London, Gower Street, London, WC1E 6BT, UK. m.singer@ucl.ac.uk
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