Introduction: Sirtuins are highly conserved nicotinamide adenine dinucleotide (NAD+) sensors that are considered the guardians of homeostasis. Acute inflammation, which is intended to ward off pathogen invasion, is nature's highly conserved stress-associated and molecular-based survival mechanism for most life forms. Acute inflammatory responses deviate cells from the homeostasis to enable survival. It is not surprising perhaps, that these two must interact in the most dramatic way to preserve homeostasis and preserve life.Areas covered: In this review, we present an overview of sirtuin responses in acute life-threatening inflammatory conditions. We examine how the seven sirtuins (sirtuins 1-7) are responsible for modulating the acute inflammatory response in a context-dependent manner, thus presenting novel therapeutic targets. The database search includes Medline (since 1966) and PubMed (since 1996).Expert opinion: Sirtuins fine-tune the inflammatory response to acute infectious and noninfectious inflammatory stimuli. Modulating sirtuin activity leads to profound changes in inflammatory response. Sirtuin-activating and inhibiting agents are emerging as therapeutic agents to resolve inflammation and promote homeostasis in chronic inflammation. The use of sirtuin modulation in acute life-threatening inflammatory conditions has great potential.
Keywords: Acute Inflammation; acute Lung Injury; hemorrhagic shock; sepsis; septic shock; sirtuin; sirtuins.