[Frontiers in Bioscience E1, 277-287, June 1, 2009]

The role of free radicals in sepsis development

Michael Everton Andrades1, Cristiane Ritter 2, Felipe Dal-Pizzol2

1Programa de Pos-Graduacao em Bioquimica, Departamento de Bioquimica, UFRGS, Brazil, 2Programa de Pos-Graduacao em Ciencias da Saude, Unidade Academica de Ciencias da Saude, UNESC, Brazil

TABLE OF CONTENTS

1. Abstract
2. Introduction
3. ROS and oxidative damage in sepsis - early mediators and late effectors
3.1. Oxidative stress and mitochondrial damage, an energy-taking process
4. Free radicals in immunologic response - a double edged sword
4.1. Free radicals as a bless
4.2. And as a curse
5. Free radicals in circulatory dysfunction
5.1. Nitric Oxide, vasodilatation and catecholamine oxidation by superoxide
5.2. Endothelial damage
5.3. Coagulopathy
6. Is there a place to antioxidants in sepsis treatment?
6.1. SOD and SOD mimetic
6.2. N-acetylcysteine and Deferoxamine
6.3. Carbonyl trap and AGE breakers
7. Perspectives
8. References

1. ABSTRACT

Sepsis is a complex inflammatory syndrome with diverse etiology and wide spectrum of severity. Several researchers have linked reactive oxygen species (ROS) and reactive nitrogen species (RNS) with the onset, progression and outcome of sepsis, both in pre-clinical and in clinical studies. ROS/RNS are important signaling molecules but its overproduction must be avoided by organism, otherwise oxidative stress takes place. Even so, the use of antioxidant as treatment in sepsis constitutes a challenge, with both null and encouraging results. In this review, it will be summarized the role of free radicals in the onset, progression and outcome of sepsis, as well as its participation in organ failure and cardiovascular collapse. Experimental treatments that may interfere in oxidative stress in sepsis will also be contemplated.