2019
DOI: 10.1007/s11064-019-02743-2
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Astroglia in Sepsis Associated Encephalopathy

Abstract: Cellular pathophysiology of sepsis associated encephalopathy (SAE) remains poorly characterised. Brain pathology in SAE, which is manifested by impaired perception, consciousness and cognition, results from multifactorial events, including high levels of systemic cytokines, microbial components and endotoxins, which all damage the brain barriers, instigate neuroinflammation and cause homeostatic failure. Astrocytes, being the principal homeostatic cells of the central nervous system contribute to the brain def… Show more

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Cited by 87 publications
(98 citation statements)
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References 192 publications
(242 reference statements)
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“…Several possible interpretations for the SAE becoming an early with bad survival organ dysfunction are as following. The rst, the brain itself is a leading organ of host response to infection, which is believed to be the blood-brain barrier (BBB) leakage due to an overwhelming in the pro-in ammatory cytokines and anti-in ammation factors released and resulted in severe in ammatory storm [15]. The severe in ammatory storm is further responsible for these in ammation factors/toxins leak into the brain, and leading to the brain edema and cerebral ischemic injure as well as cell death [15][16][17][18][19].…”
Section: Discussionmentioning
confidence: 99%
“…Several possible interpretations for the SAE becoming an early with bad survival organ dysfunction are as following. The rst, the brain itself is a leading organ of host response to infection, which is believed to be the blood-brain barrier (BBB) leakage due to an overwhelming in the pro-in ammatory cytokines and anti-in ammation factors released and resulted in severe in ammatory storm [15]. The severe in ammatory storm is further responsible for these in ammation factors/toxins leak into the brain, and leading to the brain edema and cerebral ischemic injure as well as cell death [15][16][17][18][19].…”
Section: Discussionmentioning
confidence: 99%
“…The novelty of this study is a first to report that 97.2% of sepsis patients had a SABD with bad outcome, and unused a rapid antibiotic treatment within the initial 0.5 to 3.0 hours after an early suspected infection event plays a vital role in advancement of high morbidity and high risk of death in SABD. In addition, this high prevalence of SABD with bad outcome can also be explained by the following several points: (1) the low prevalence of SAE in the ICU was from a population without stroke or traumatic brain injure [11,12], whereas, our current study is included these septic patients from stroke and trauma [2,13,15]; (2) our SABD patients were generally associated with a SIRS ā‰„2, which involves the pathogenesis of SABD contributed by Bone [27], i.e., the cytokines lead to blood brain barrier leakage and cell death [28]. A mixed SABD can be considered if accompanied by a primary brain injure; (3) most SABD in our series is presented with MODS, and the previous studies also indicated that sepsis patients with MODS were more likely to exhibit a SAE [12,21,29,30].…”
Section: Discussionmentioning
confidence: 99%
“…Brain injury is one of the most common and early outcomes of multiple organ dysfunction syndromes (MODS) in sepsis (Dal-Pizzol et al, 2014). SAE is generally considered the primary factor determining the clinical evolution and prognosis of sepsis (Shulyatnikova and Verkhratsky, 2019). It is, therefore, of great importance to study the pathogenesis of SAE to identify effective treatments, thereby improving prognosis and reducing the social and economic burden of patients diagnosed with sepsis.…”
Section: Introductionmentioning
confidence: 99%
“…Glial cells, in particular, are responsible for central nervous system homeostasis (Verkhratsky and Butt, 2013). Astrocytes, the most abundant glial cells in the brain, have many functions, including maintenance of ion and fluid balance, neurotransmitter metabolism, neurogenesis, maintenance of synaptic connections, and synaptic plasticity (Shulyatnikova and Verkhratsky, 2019). The defensive function of astrocytes is characterized by astrogliosis, which is a multicomponent and complex remodeling of astrocytes caused by damage to the central nervous system (Brosius Lutz et al, 2014).…”
Section: Introductionmentioning
confidence: 99%