Histopathological changes of organ dysfunction in sepsis

Area of Science:

• Pathology
• Sepsis Research
• Organ Dysfunction

Background:

• Sepsis is a life-threatening condition characterized by organ dysfunction.
• Current definitions of organ dysfunction rely on clinical, physiological, or biochemical markers, not clinicopathological entities.
• The pathogenesis and specific treatments for sepsis-induced organ dysfunction remain largely unknown.

Purpose of the Study:

• To review and synthesize histopathological findings in human sepsis-induced organ dysfunction.
• To elucidate the pathogenesis of organ dysfunction in sepsis through histological analysis.
• To identify potential therapeutic targets and diagnostic biomarkers based on histopathology.

Main Methods:

• Comprehensive literature search of PubMed, EMBASE, and Scielo databases.
• Inclusion of original articles focusing on kidney, brain, and liver dysfunction in human sepsis.
• Review and discussion of studies reporting histopathological changes associated with sepsis.

Main Results:

• Sepsis-induced acute kidney injury shows predominant apoptosis, interstitial inflammation, and thrombosis over acute tubular necrosis.
• Brain pathology in sepsis includes white matter hemorrhage, hypercoagulability, microabscesses, and metabolic/ischemic changes.
• Liver pathology involves steatosis, cholangiolitis, intrahepatic cholestasis, periportal inflammation, and apoptosis.
• No correlation found between histopathological findings and existing physiological or biochemical biomarkers.

Conclusions:

• Histopathological examination offers critical insights into sepsis pathogenesis and potential therapeutic strategies.
• There is a significant need for clinically applicable biomarkers that reflect histological organ damage in sepsis.
• Further research correlating histopathology with clinical data is essential for advancing sepsis management.