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2017 ; 28
(2
): 134-141
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Advances in the Diagnosis of Sepsis: Hydrogen Sulfide as a Prognostic Marker of
Septic Shock Severity
#MMPMID28757821
Ko?ir M
; Podbregar M
EJIFCC
2017[May]; 28
(2
): 134-141
PMID28757821
show ga
Hydrogen sulfide (H(2)S) is a third known gasotransmitter. Most of the time it
was knows as a poisonous gas. In last 30 years, we are seeing change in its
perception. Scientists have discovered its major role in different organ systems.
It is endogenously produced in various tissues and its production is influenced
by many factors. In normal, physiological conditions only 20% of H(2)S is in its
free form. The role of H(2)S is very wide. It acts as a signaling molecule, has
influence on vascular tone, inflammatory response, scavenges reactive oxygen
species, can be cytoprotective and can even reduce the extent of myocardial
ischemia. Different studies have shown H(2)S has considerable influence in
pathology of sepsis and its outcome. High free plasma levels of H(2)S are
predictor of unfavorable outcome. Findings show that moderate free plasma levels
of H(2)S have protective effect. Paradoxical very low free plasma levels of
H(2)S, seen in patients with chronic heart failure, are also predictor of
severity of disease and poor outcome. We presume that relationship between
morbidity/mortality and concentration of H(2)S has a wide U-shape curve
dependence. New researches with discovery of H(2)S agonists and antagonists could
open new ways in understanding different pathologies and ability to treat them.
Recent advances in the identification of H(2)S agonists and antagonists may help
in forwarding our understanding of pathomechanisms and hence their treatment.