title: THE EPITHELIUM AS A TARGET IN SEPSIS.
abstract: Organ dysfunction induced by sepsis has been consistently associated with worse outcome and death. Regardless of the organ compromised, epithelial dysfunction is present throughout the body, affecting those organs that contain epithelia like the skin, lungs, liver, gut, and kidneys. Despite their obvious differences, sepsis seems to alter common features of all epithelia, such as barrier function and vectorial ion transport. Such alterations in the lung, the gut, and the kidney have direct implications that may explain the profound organ functional impairments in the absence of overt cell death. Epithelial injury in this context is not only an explanatory real pathophysiologic event, but also represents a source of biomarkers that have been explored to identify organ compromise earlier, predict outcome, and even to test novel therapeutic interventions such as blood purification. However, this remains largely experimental, and despite promising results, work is still required to better understand the response of the epithelial cells to sepsis, to define their role in adaptation to insults, to comprehend the interorgan cross-talk that occurs in these circumstances, and to exploit these aspects in pursuit of targeted therapies like blood purification, which may improve outcome for these patients in the future.
authors: *Department of Medicine, Veterans Affairs Medical Center, Washington, District of Columbia †Departments of Surgery and Anesthesiology, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California ‡Center for Acute Care Nephrology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio §Infectious Disease Division, Alpert Medical School of Brown University, Providence, Rhode Island ||Academia Colombiana de Medicina Critica (ACOMEC) ¶Division of Critical Care Medicine, Clínica Palermo, Bogotá, Colombia #University College Dublin, Dublin, Ireland **Center for Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors: Lakhmir S
authors: LS
authors: Chawla
authors: Mitchell
authors: M
authors: Fink
authors: Stuart L
authors: SL
authors: Goldstein
authors: Steven
authors: S
authors: Opal
authors: Alonso
authors: A
authors: Gómez
authors: Patrick
authors: P
authors: Murray
authors: Hernando
authors: H
authors: Gómez
authors: John A
authors: JA
authors: Kellum
mesh_terms: D000818:Animals; D004847:Epithelial Cells / Q000378:metabolism* / Q000473:pathology; D004848:Epithelium / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D017136:Ion Transport; D009928:Organ Specificity; D018805:Sepsis / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology*