Multiple organ dysfunction syndrome: molecular mechanisms and therapeutic strategies

Multiple organ dysfunction syndrome presents a significant challenge in clinical critical care, characterized by the progressive or simultaneous failure of two or more organ systems following severe insults such as infection, trauma, acute pancreatitis, shock, burns, or other major events. Recent advancements in research have deepened the understanding of organ dysfunction, with a shift toward investigating organ injury and organ-specific diseases. The pathogenesis of MODS is intricate and driven by dynamic interactions across multiple levels, including inflammatory responses, microcirculatory disruptions, coagulation abnormalities, cell death, DNA damage and the production of reactive oxygen species. Recent innovations in single-cell technologies, spatial omics and organoid models have opened new avenues for exploring intercellular signaling, targeting damaged tissues and advancing drug development. Current therapeutic approaches for MODS involve comprehensive strategies, such as aggressive management of underlying causes, organ support, modulation of immune and inflammatory responses, nutritional intervention and stabilization of the internal environment. Despite these efforts, mortality rates remain high, and therapeutic advancements have yet to yield optimal results. This highlights the urgent need for continued research to translate scientific discoveries into clinical breakthroughs. Further exploration of the disease's pathogenesis, identification of early diagnostic biomarkers and development of novel, effective treatments are crucial to improving treatment outcomes and reducing mortality in critically ill patients.