A Novel Therapeutic Strategy for Sepsis: The Multiorgan Protective Properties and Clinical Potential of Ulineastatin

Sepsis, a life-threatening systemic inflammatory response induced by infection, remains a major therapeutic challenge with high mortality rates, especially when progressing to multiple organ dysfunction syndrome. Ulinastatin (UTI), a serine protease inhibitor with anti-inflammatory and antioxidative properties, has emerged as a promising therapeutic candidate for sepsis-induced organ injury. This article systematically reviews recent advances in the multiorgan protective effects of UTI against sepsis, focusing on its mechanisms through modulating key signaling pathways, reducing inflammatory cytokine release, inhibiting oxidative stress, and regulating cellular apoptosis/autophagy. Clinical and preclinical evidence demonstrates UTI's efficacy in alleviating injury in critical organs, including lungs, heart, liver, spleen, intestines, and kidneys. The current review clarifies the mechanism by which UTI mitigates sepsis-related multiple organ dysfunction syndrome and provides a theoretical basis for identifying potential therapeutic targets of UTI to mitigate sepsis injury.