Sepsis-Associated Muscle Wasting: A Comprehensive Review from Bench to Bedside

Int J Mol Sci. 2023 Mar 6;24(5):5040. doi: 10.3390/ijms24055040.

Abstract

Sepsis-associated muscle wasting (SAMW) is characterized by decreased muscle mass, reduced muscle fiber size, and decreased muscle strength, resulting in persistent physical disability accompanied by sepsis. Systemic inflammatory cytokines are the main cause of SAMW, which occurs in 40-70% of patients with sepsis. The pathways associated with the ubiquitin-proteasome and autophagy systems are particularly activated in the muscle tissues during sepsis and may lead to muscle wasting. Additionally, expression of muscle atrophy-related genes Atrogin-1 and MuRF-1 are seemingly increased via the ubiquitin-proteasome pathway. In clinical settings, electrical muscular stimulation, physiotherapy, early mobilization, and nutritional support are used for patients with sepsis to prevent or treat SAMW. However, there are no pharmacological treatments for SAMW, and the underlying mechanisms are still unknown. Therefore, research is urgently required in this field.

Keywords: ICU; critically ill; muscle wasting; post-intensive care syndrome; sepsis.

Publication types

  • Review

MeSH terms

  • Humans
  • Muscle Fibers, Skeletal / metabolism
  • Muscle, Skeletal / metabolism
  • Muscular Atrophy / metabolism
  • Proteasome Endopeptidase Complex* / metabolism
  • Sepsis* / metabolism
  • Ubiquitin / metabolism

Substances

  • Proteasome Endopeptidase Complex
  • Ubiquitin