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Metabolism modulators in sepsis: the abnormal pituitary response
Virginie Maxime1, Shidasp Siami, Djillali Annane
1Service de Réanimation, Hôpital Raymond Poincaré, Assistance Publique-Hôpitaux de Paris, Faculté de médecine Paris Ile de France Ouest, Université de Versailles Saint-Quentin-en-Yvelines, Garches, France.
Critical Care Medicine
|September 22, 2007
Summary
Sepsis significantly alters the hypothalamic-pituitary axis, affecting hormone secretion. Understanding these changes, particularly concerning adrenocorticotropin and vasopressin, is crucial for managing sepsis progression and patient outcomes.
Area of Science:
- Endocrinology
- Immunology
- Neuroscience
Background:
- The hypothalamic-pituitary axis plays a critical role in the body's response to stress and infection.
- Sepsis, a life-threatening condition, involves a dysregulated immune response that can impact multiple organ systems, including the endocrine system.
Purpose of the Study:
- To review and summarize the current understanding of the hypothalamic-pituitary axis's involvement in the development and progression of sepsis.
- To highlight the hormonal changes and their implications during septic conditions.
Main Methods:
- Systematic literature search of MEDLINE and Embase databases up to December 2006.
- Inclusion of relevant references from retrieved articles.
Main Results:
- Sepsis activates the pituitary gland through cytokines and neuro-immune interactions.
- Characterized by rapid increases in adrenocorticotropin and prolactin, and inhibition of luteinizing and thyroid-stimulating hormones.
- Nitric oxide is identified as a key mediator of abnormal pituitary responses, with low adrenocorticotropin and vasopressin levels contributing to shock and organ failure.
Conclusions:
- Sepsis induces significant alterations in hypothalamic-pituitary axis function.
- Targeting pituitary function during sepsis presents a significant challenge for future research and clinical management.
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