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      Sepsis-mediated renal dysfunction: Pathophysiology, biomarkers and role of phytoconstituents in its management.

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          Abstract

          Sepsis has evolved as an enormous health issue amongst critically ill patients. It is a major risk factor that results in multiple organ failure and shock. Acute kidney injury (AKI) is one of the most frequent complications underlying sepsis, which portends a heavy burden of mortality and morbidity. Thus, the present review is aimed to provide an insight into the recent progression in the molecular mechanisms targeting dysregulated immune response and cellular dysfunction involved in the development of sepsis-associated AKI, accentuating the phytoconstituents as eligible candidates for attenuating the onset and progression of sepsis-associated AKI. The pathogenesis of sepsis-mediated AKI entails a complicated mechanism and is likely to involve a distinct constellation of hemodynamic, inflammatory, and immune mechanisms. Novel biomarkers like neutrophil gelatinase-associated lipocalin, soluble triggering receptor expressed on myeloid cells 1, procalcitonin, alpha-1-microglobulin, and presepsin can help in a more sensitive diagnosis of sepsis-associated AKI. Many bioactive compounds like curcumin, resveratrol, baicalin, quercetin, and polydatin are reported to play an important role in the prevention and management of sepsis-associated AKI by decreasing serum creatinine, blood urea nitrogen, cystatin C, lipid peroxidation, oxidative stress, IL-1β, TNF-α, NF-κB, and increasing the activity of antioxidant enzymes and level of PPARγ. The plant bioactive compounds could be developed into a drug-developing candidate in managing sepsis-mediated acute kidney injury after detailed follow-up studies. Lastly, the gut-kidney axis may be a more promising therapeutic target against the onset of septic AKI, but a deeper understanding of the molecular pathways is still required.

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          Author and article information

          Journal
          Biomed Pharmacother
          Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie
          Elsevier BV
          1950-6007
          0753-3322
          Sep 2023
          : 165
          Affiliations
          [1 ] Patanjali Herbal Research Department, Patanjali Research Institute, Haridwar, India.
          [2 ] Patanjali Herbal Research Department, Patanjali Research Institute, Haridwar, India. Electronic address: dr.ashwanikumar@patanjali.res.in.
          [3 ] Department of Neurology, Charles University in Prague, Faculty of Medicine in Hradec Králové and University Hospital, Hradec Králové, Czech Republic.
          [4 ] Department of Chemistry, Faculty of Science, University of Hradec Kralove, Hradec Kralove, Czech Republic; Biomedical Research Center, University Hospital in Hradec Kralove, Sokolska 581, Hradec Kralove, Czech Republic. Electronic address: kamil.kuca@uhk.cz.
          [5 ] School of Bioengineering and Food Technology, Shoolini University of Biotechnology and Management Sciences, Solan, India.
          [6 ] Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland.
          Article
          S0753-3322(23)00974-5
          10.1016/j.biopha.2023.115183
          37487442
          52867602-a280-4537-a1b2-200debf6b827
          History

          Biomarkers,Sepsis,Pyroptosis,Plant bioactive compounds,Gut-kidney axis,Acute kidney injury

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