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Published on: June 15, 2019
[Neuroendocrine dysfunction in sepsis and its therapeutic strategy]
Qing-hong Zhang1, Yong-ming Yao
1Burns Institute, the First Hospital Affiliated to the PLA General Hospital, Beijing 100048, China.
Summary
Severe sepsis disrupts the neuroendocrine system, causing hormone resistance and autonomic dysfunction. Current treatments target hyperglycemia and blood pressure, with future therapies aiming to reduce inflammation and encephalopathy.
Area of Science:
- Endocrinology
- Neuroscience
- Immunology
Context:
- Severe sepsis significantly impacts the host neuroendocrine system.
- Characterized by glucocorticoid and growth hormone resistance, vasopressin deficiency, and reduced vagal activity.
- Leads to hyperdynamic circulation, hypermetabolism, and hyperglycemia/insulin resistance.
Purpose:
- To outline the neuroendocrine and autonomic abnormalities in severe sepsis.
- To review current therapeutic strategies.
- To suggest future therapeutic directions.
Summary:
- Sepsis induces neuroendocrine dysregulation, including hormone resistance and autonomic dysfunction.
- Manifestations include hyperdynamic state, hyperglycemia, and insulin resistance.
- Current treatments involve insulin, corticosteroids, growth hormone, and vasopressin; beta-blockade is also explored.
Impact:
- Understanding these complex interactions is crucial for effective sepsis management.
- Highlights the need for therapies addressing both central and peripheral immune responses.
- Potential to alleviate hyperdynamic inflammatory states and sepsis-induced encephalopathy.
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