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Pathophysiology of sepsis.

Pietro Arina1, Mervyn Singer

  • 1Bloomsbury Institute for Intensive Care Medicine, Division of Medicine, University College London, London, UK.

Current Opinion in Anaesthesiology
|March 2, 2021
PubMed
Summary

Sepsis involves an exaggerated host response to infection, leading to organ dysfunction. This review explores the complex mechanisms of this dysregulated response, shifting focus from the pathogen to the host's reaction.

Area of Science:

  • Critical Care Medicine
  • Immunology
  • Pathophysiology

Background:

  • Sepsis is a life-threatening condition characterized by organ dysfunction.
  • Traditionally, sepsis research focused on the causative pathogen.
  • Current understanding emphasizes the host's immune and inflammatory response.

Purpose of the Study:

  • To present a contemporary overview of sepsis pathophysiology.
  • To highlight the shift in focus from pathogen to host response.
  • To elucidate the mechanisms driving organ dysfunction in sepsis.

Main Methods:

  • Literature review of current sepsis research.
  • Synthesis of recent findings on host response pathways.
  • Analysis of the transition from adaptive to maladaptive responses.

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Main Results:

  • Sepsis pathophysiology is characterized by an exaggerated host response, not solely the pathogen.
  • The host response involves dysregulated activation or suppression of multiple signaling pathways.
  • These pathways lead to circulatory and metabolic disturbances, resulting in multiple organ dysfunction.

Conclusions:

  • Sepsis is a dysregulated host response to infection causing organ dysfunction.
  • The initial host response, though exaggerated, may be protective but can lead to harm.
  • Understanding these complex mechanisms is crucial for developing effective sepsis therapies.