Immunometabolism in Sepsis

Anasthesiol Intensivmed Notfallmed Schmerzther. 2024 Feb;59(2):78-94. doi: 10.1055/a-2070-3170. Epub 2024 Feb 14.ABSTRACTImmunometabolism is a fascinating field of research that investigates the interactions between metabolic processes and the immune response. This intricate connection plays a pivotal role in regulating inflammatory reactions and consequently exerts a significant impact on the course of sepsis. The proinflammatory response during an immune reaction is closely tied to a high energy demand in immune cells. As a result, proinflammatory immune cells rapidly require substantial amounts of energy in the form of ATP, necessitating a fundamental and swift shift in their metabolism, i.e., their means of generating energy. This entails a marked increase in glycolysis within the proinflammatory response, thereby promptly meeting the energy requirements and providing essential metabolic building blocks for the biosynthesis of macromolecules. Alongside glycolysis, there is heightened activity in the pentose phosphate pathway (PPP). The PPP significantly contributes to NADPH production within the cell, thus maintaining redox equilibrium. Elevated PPP activity consequently leads to an increased NADPH level, resulting in enhanced production of reactive oxygen species (ROS) and nitric oxide (NO). While these molecules are crucial for pathogen elimination, an excess can also induce tissue damage. Simultaneously, there are dual interruptions in the citric acid cycle. In the cel...

Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - February 14, 2024 Category: Intensive Care Authors: Bj örn Koos Matthias Unterberg Tim Rahmel Michael Adamzik Source Type: research