HYPOCHOLESTEROLEMIA IN SEPTIC CONDITIONS. MECHANISMS OF DEVELOPMENT AND WAYS OF CORRECTION

Abstract

Sepsis is one of the significant problems in medicine for many decades. It is characterized by high levels of morbidity, mortality and high financial costs. The review is devoted to the cellular and molecular biological mechanisms of sepsis, including immune, biochemical changes, mitochondrial transformations, coagulopathy, neuroendocrine disorders, damage to the endoplasmic reticulum and a number of other processes that ultimately lead to multiple organ fail-ure. The article presents two directions of development of cellular and molecular biological changes in generalized inflammation, ending with a favorable or unfavorable outcome. Information on changes in the transport of cholesterol and polyunsaturated fatty acids in tissues against the background of septic processes is summarized. The mechanisms of reducing the concentration of cholesterol in tissues, the influence of hypocholesterolemia on the course of a gen-eralized inflammatory process and the development of such complications as Waterhouse – Friderichsen syndrome are discussed in detail. A concept of a chain of pathogenetic changes causing lethal outcome has been formed, and on its basis, methods for correcting metabolism in sepsis described in the literature (intravenous administration of reduced high-density lipoproteins, inhibition of proprotein convertase subtilisin kexin 9) are considered. For the first time, the concept of treating septic conditions with cholesterol in the composition of liposomes was proposed.

Keywords

• сепсис
• гипохолестеролемия
• синдром уотерхауса-фридериксена
• липосомы.