Hypercatabolism and Anti-catabolic Therapies in the Persistent Inflammation, Immunosuppression, and Catabolism Syndrome

Jinlin Zhang; Wenchen Luo; Changhong Miao; Jing Zhong

doi:10.3389/fnut.2022.941097

Hypercatabolism and Anti-catabolic Therapies in the Persistent Inflammation, Immunosuppression, and Catabolism Syndrome

Front Nutr. 2022 Jul 13:9:941097. doi: 10.3389/fnut.2022.941097. eCollection 2022.

Authors

Jinlin Zhang¹, Wenchen Luo¹, Changhong Miao¹, Jing Zhong^{1

2

3

4}

Affiliations

¹ Department of Anesthesiology, Zhongshan Hospital Fudan University, Shanghai, China.
² Fudan Zhangjiang Institute, Shanghai, China.
³ Department of Anesthesiology, Zhongshan Wusong Hospital, Fudan University, Shanghai, China.
⁴ Shanghai Key Laboratory of Perioperative Stress and Protection, Shanghai, China.

Abstract

Owing to the development of intensive care units, many patients survive their initial insults but progress to chronic critical illness (CCI). Patients with CCI are characterized by prolonged hospitalization, poor outcomes, and significant long-term mortality. Some of these patients get into a state of persistent low-grade inflammation, suppressed immunity, and ongoing catabolism, which was defined as persistent inflammation, immunosuppression, and catabolism syndrome (PICS) in 2012. Over the past few years, some progress has been made in the treatment of PICS. However, most of the existing studies are about the role of persistent inflammation and suppressed immunity in PICS. As one of the hallmarks of PICS, hypercatabolism has received little research attention. In this review, we explore the potential pathophysiological changes and molecular mechanisms of hypercatabolism and its role in PICS. In addition, we summarize current therapies for improving the hypercatabolic status and recommendations for patients with PICS.

Keywords: and catabolism syndrome; anti-catabolic therapy; chronic critical illness; gut dysfunction; hypercatabolism; immunosuppression; mitochondrial dysfunction; persistent inflammation.

Publication types

Review