Nedel W, Deutschendorf C, Portela LVC. Sepsis-induced mitochondrial dysfunction: A narrative review. World J Crit Care Med 2023; 12(3): 139-152 [PMID: 37397587 DOI: 10.5492/wjccm.v12.i3.139]
Corresponding Author of This Article
Wagner Nedel, MD, MHSc, Assistant Professor, Medical Assistant, Intensive Care Unit, Grupo Hospitalar Conceição, Francisco Trein 596, Segundo Andar, Porto Alegre 91350200, Brazil. wagnernedel@gmail.com
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Crit Care Med. Jun 9, 2023; 12(3): 139-152 Published online Jun 9, 2023. doi: 10.5492/wjccm.v12.i3.139
Sepsis-induced mitochondrial dysfunction: A narrative review
Wagner Nedel, Caroline Deutschendorf, Luis Valmor Cruz Portela
Wagner Nedel, Intensive Care Unit, Grupo Hospitalar Conceição, Porto Alegre 91350200, Brazil
Wagner Nedel, Luis Valmor Cruz Portela, Laboratory of Neurotrauma and Biomarkers, Departamento de Bioquímica, ICBS, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-003, Brazil
Wagner Nedel, Brazilian Research in Intensive Care Network-BRICNet, São Paulo 04039-002, Brazil
Caroline Deutschendorf, Infection Control Committee, Hospital de Clínicas de Porto Alegre, Porto Alegre 90410-000, Brazil
Author contributions: Nedel W contributed to research, wrote the manuscript, reviewed the final version, and made the graphs and figures; Deutschendorf C contributed to write the manuscript and reviewed the final version; Portela LVC contributed to write the manuscript, reviewed the final version.
Supported bythe Fundação de Amparo a Pesquisa do Estado do Rio Grande do Sul, No. 1010267.
Conflict-of-interest statement: The authors state that there was no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wagner Nedel, MD, MHSc, Assistant Professor, Medical Assistant, Intensive Care Unit, Grupo Hospitalar Conceição, Francisco Trein 596, Segundo Andar, Porto Alegre 91350200, Brazil. wagnernedel@gmail.com
Received: January 20, 2023 Peer-review started: January 20, 2023 First decision: February 20, 2023 Revised: March 8, 2023 Accepted: April 14, 2023 Article in press: April 14, 2023 Published online: June 9, 2023
Abstract
Sepsis represents a deranged and exaggerated systemic inflammatory response to infection and is associated with vascular and metabolic abnormalities that trigger systemic organic dysfunction. Mitochondrial function has been shown to be severely impaired during the early phase of critical illness, with a reduction in biogenesis, increased generation of reactive oxygen species and a decrease in adenosine triphosphate synthesis of up to 50%. Mitochondrial dysfunction can be assessed using mitochondrial DNA concentration and respirometry assays, particularly in peripheral mononuclear cells. Isolation of monocytes and lymphocytes seems to be the most promising strategy for measuring mitochondrial activity in clinical settings because of the ease of collection, sample processing, and clinical relevance of the association between metabolic alterations and deficient immune responses in mononuclear cells. Studies have reported alterations in these variables in patients with sepsis compared with healthy controls and non-septic patients. However, few studies have explored the association between mitochondrial dysfunction in immune mononuclear cells and unfavorable clinical outcomes. An improvement in mitochondrial parameters in sepsis could theoretically serve as a biomarker of clinical recovery and response to oxygen and vasopressor therapies as well as reveal unexplored pathophysiological mechanistic targets. These features highlight the need for further studies on mitochondrial metabolism in immune cells as a feasible tool to evaluate patients in intensive care settings. The evaluation of mitochondrial metabolism is a promising tool for the evaluation and management of critically ill patients, especially those with sepsis. In this article, we explore the pathophysiological aspects, main methods of measurement, and the main studies in this field.
Core Tip: The evaluation of mitochondrial metabolism is a promising tool for the evaluation and management of critically ill patients, particularly those with sepsis. In this article, we explore the pathophysiological aspects, main methods of measurement, and main studies in this field.
