Sepsis Essay

During trauma/sepsis a patient experiences innate immune responses and associated metabolic alterations. The amount of fat a person has affects the response to these metabolic alterations. It is proposed that adipocyte changes during sepsis provide mediation of innate immune responses resulting in greater survival rates of obese patients. Metabolic shifts during trauma/sepsis occur to oblige the body’s need for increased energy. This results in high levels of glucose, fatty acids (FA), and amino acids (AA) circulating in the blood. Simultaneously, the inflammatory response induces insulin resistance, preventing the body from using this fuel and driving septic persistence. Changes in the functionality of fat stores during sepsis may mediate …show more content…
This morphological change during sepsis renders fat cells more able to intake circulating glucose and FA liberated through septic induced metabolic alterations. Lipogenic enzymes (acetyl CoA carboxylase and fatty acid synthase) are elevated in the fat cells during trauma/sepsis. This fosters greater FA and glucose storage in fat cells. Thus, smaller fat cells and increased lipogenic enzymes increase the removal of glucose from the bloodstream, decreasing inflammation, and aiding in sepsis …show more content…
M1 macrophages, activated in sepsis/trauma enhance pro-inflammatory cytokines, specifically nitrous oxide (NO) inducing vasodilation leading to low blood pressure and hypoxia. M2 macrophages secrete anti-inflammatory cytokines. Sepsis/trauma patients with greater stores of fat deposits show increased levels of anti-inflammatory M2 macrophages. Greater levels of M2 macrophages lead to less inflammation and mitigation of the insulin resistance induced by pro-inflammatory cytokines. Obese patients have more fat cells that shrink in response to sepsis. This creates greater glucose clearance and lipid storage as well as more M2 macrophages to decrease inflammation than in patients with fewer fat