4.6 Review

The role of phytochemicals in sepsis: A mechanistic and therapeutic perspective

Journal

BIOFACTORS
Volume 47, Issue 1, Pages 19-40

Publisher

WILEY
DOI: 10.1002/biof.1694

Keywords

herbal medicine; inflammation; intensive care units; phytochemical; sepsis

Funding

  1. [IR.MUI.MED.REC.1399.601]

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Sepsis and septic shock remain significant causes of mortality and morbidity worldwide, characterized by an uncontrolled immune response and excessive pro-inflammatory mediator production. Understanding the pathophysiology and molecular mechanisms of sepsis can aid in the development of new effective therapeutics. Natural bioactive herbal compounds and phytochemicals show promise in attenuating inflammatory responses and offering cytoprotective effects in sepsis patients.
Sepsis and septic shock are still a leading cause of mortality and morbidity in intensive care units worldwide. Sepsis is an uncontrolled and excessive response of the innate immune system toward the invading infectious microbes, characterized by the hyper-production of pro-inflammatory mediators such as interleukin (IL)-1 beta, IL-6, tumor-necrosis factor (TNF)-alpha, and high-mobility group box 1 (HMGB1). In severe sepsis, the overwhelming production of pro-inflammatory cytokines and reactive oxygen species may compromise organ function and lead to the induction of abnormal apoptosis in different organs, resulting in multiple organ dysfunction syndrome and death. Hence, compounds that are able to attenuate inflammatory responses may have therapeutic potential for sepsis treatment. Understanding the pathophysiology and underlying molecular mechanisms of sepsis may provide useful insights in the discovery and development of new effective therapeutics. Therefore, numerous studies have invested much effort into elucidating the mechanisms involved with the onset and development of sepsis. The present review mainly focuses on the molecules and signaling pathways involved in the pathogenicity of sepsis. Additionally, several well-known natural bioactive herbal compounds and phytochemicals, which have shown protective and therapeutic effects with regard to sepsis, as well as their mechanisms of action, are presented. This review suggests that these phytochemicals are able to attenuate the overwhelming inflammatory responses developed during sepsis by modulating different signaling pathways. Moreover, the anti-inflammatory and cytoprotective activities of phytochemicals make them potent compounds to be included as complementary therapeutic agents in the diets of patients suffering from sepsis in an effort to alleviate sepsis and its life-threatening complications, such as multi-organ failure.

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