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Science review: The brain in sepsis – culprit and victim

Authors
  • Sharshar, Tarek1
  • Hopkinson, Nicholas S2
  • Orlikowski, David1
  • Annane, Djillali3
  • 1 Université de Versailles Saint-Quentin-en-Yvelines, Attending Physician, Service de Réanimation Médicale, Hôpital Raymond Poincaré, Garches, France , Garches
  • 2 Royal Brompton and Harefield NHS Trust, Attending Physician, Respiratory Muscle Laboratory, Fulham Road, London, SW3 6NP, United Kingdom , London
  • 3 Université de Versailles Saint-Quentin-en-Yvelines, Head of ICU Department, Service de Réanimation Médicale, Hôpital Raymond Poincaré, Garches, France , Garches
Type
Published Article
Journal
Critical Care
Publisher
BioMed Central
Publication Date
Sep 08, 2004
Volume
9
Issue
1
Identifiers
DOI: 10.1186/cc2951
Source
Springer Nature
Keywords
License
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Abstract

On one side, brain dysfunction is a poorly explored complication of sepsis. On the other side, brain dysfunction may actively contribute to the pathogenesis of sepsis. The current review aimed at summarizing the current knowledge about the reciprocal interaction between the immune and central nervous systems during sepsis. The immune-brain cross talk takes part in circumventricular organs that, being free from blood-brain-barrier, interface between brain and bloodstream, in autonomic nuclei including the vagus nerve, and finally through the damaged endothelium. Recent observations have confirmed that sepsis is associated with excessive brain inflammation and neuronal apoptosis which clinical relevance remains to be explored. In parallel, damage within autonomic nervous and neuroendocrine systems may contribute to sepsis induced organ dysfunction.

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