The immune system helps clear infections and fight pathogens. However, it can occasionally overreact. When the response to infection becomes excessive, it can cause rapid and widespread organ damage, which is called sepsis. Sepsis is a life-threatening condition and imposes social, economic, and health costs.
A team of researchers from France examined the mechanisms by which corticosteroids limit sepsis-related damage to the body. It was led by Professor Djillali Annane from IHU SEPSIS Comprehensive Sepsis Center at the Raymond Poincaré Hospital, APHP University Versailles Saint Quentin–University Paris Saclay.
Prof Annane says,
Although international guidelines have helped reduce crude mortality rates from sepsis, there are still no specific therapies other than corticosteroids. Our objectives were to provide the most recent data on corticosteroids, as well as up-to-date evidence regarding their effects in patients with sepsis.
The team reviewed around hundred articles studying the multiple effects of corticosteroids against the symptoms of sepsis. Corticosteroids worked by stabilizing the mitochondria in the dysfunctional immune cells. In addition, it also switched these cells from releasing molecules to those that decrease inflammation than increasing it. Furthermore, corticosteroids also lowered the release of molecules that cause unregulated cell death called necrosis. Eventually, these changes led to the reduction in stress on tissues and organs, helping improve sepsis.
The team cited multiple studies, all of which included the benefits of high-dose corticosteroid treatment against sepsis in a clinical setting. Moreover, high-dose corticosteroids also reduce the length of hospital admission required to recover from sepsis.
Prof Annane points out
There was moderate to high certainty of an increased risk of elevated glucose and sodium levels in the blood. Furthermore, use of corticosteroids during the recent coronavirus disease (COVID-19) pandemic appears to have been associated with an increased risk of opportunistic infections,
Further concluding
the use of moderate doses of corticosteroids for a week or two in patients with sepsis is supported by biological and pharmacological rationale, evidence from clinical trials, and high-quality systematic reviews and meta-analyses, as well as clinical practice guidelines.
