Pathophysiologie der Sepsis
und deren mögliche Beeinflussung durch HMG-CoA-Reduktase-Inhibitoren

P Fraunberger; H Drexel; A K Walli

doi:10.1055/s-0030-1267491

DMW - Deutsche Medizinische Wochenschrift, Inhaltsverzeichnis

Dtsch Med Wochenschr 2010; 135(43): 2128-2132
DOI: 10.1055/s-0030-1267491

Übersicht | Review article

Intensivmedizin
© Georg Thieme Verlag KG Stuttgart · New York

Pathophysiologie der Sepsis und deren mögliche Beeinflussung durch HMG-CoA-Reduktase-Inhibitoren

Pathophysiology of sepsis and possible influence of statinsP. Fraunberger¹ , H. Drexel² , A. K. Walli³

¹Medizinisches Zentrallabor, Feldkirch, Österreich
²Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Österreich
³Institut für Klinische Chemie, Klinikum Großhadern, Ludwig-Maximilians-Universität München

Abstract

Zusammenfassung

Sepsis, schwere Sepsis und septischer Schock stellen häufige Komplikationen auf Intensivstationen dar und sind mit hoher Mortalität behaftet. Neben einer möglichst frühzeitigen Infektbekämpfung und Fokussanierung stellen Kreislauf- und Organ-Unterstützende Maßnahmen die wesentlichen Säulen der Therapie dar. Zur Therapie der Entzündungsreaktion wurden in den vergangen Jahren zunehmend immunmodulatorische Therapien untersucht.

Aufgrund der pleiotropen Effekte der HMG-CoA-Reduktase-Inhibitoren (Statine), zu denen auch antiinflammatorische Eigenschaften gehören, könnten diese Medikamente zukünftig eine neue adjuvante Therapieoption darstellen. Im Gegensatz zu anderen anti-entzündlichen Therapien wäre hier auch ein prophylaktischer Einsatz bei Hochrisikopatienten möglich. Die pathophysiologischen Hintergründe und erste Studiendaten zur Bedeutung von Statinen bei akuten Entzündungsreaktionen sind in der vorliegenden Arbeit zusammengefasst.

Abstract

Severe sepsis and septic shock are common complications in the intensive care unit and associated with high mortality. Early antimicrobial therapies together with organ-supportive measures are the major therapeutic approaches. However in the last decades immunmodulatory therapies have been investigated due to the notion of a compromised inflammatory response in septic patients.

In addition to lowering circulating cholesterol, statins (HMG-CoA-reductase-inhibitors) have also been shown to possess pleiotropic anti-inflammatory potential. Recent studies indicate that these anti-inflammatory effects also modulate acute inflammatory response and therefore may play a protective role in septic patients. In this review, the pathophysiological backround and first clinical trials of statins as a new adjuvant therapy in sepsis are summarized.

Schlüsselwörter

Statine - Sepsis - Cholesterin

Keywords

statins - sepsis - cholesterin

Volltext

Referenzen

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PD Dr. med. Peter Fraunberger

Medizinisches Zentrallabor

Carinagasse 41

A-6800 Feldkirch

eMail: pfraunberger@mzl.at