PMID- 38068931
OWN - NLM
STAT- MEDLINE
DCOM- 20231216
LR  - 20231216
IS  - 1422-0067 (Electronic)
IS  - 1422-0067 (Linking)
VI  - 24
IP  - 23
DP  - 2023 Nov 22
TI  - Impact of Treatment with Antioxidants as an Adjuvant to Standard Therapy in 
      Patients with Septic Shock: Analysis of the Correlation between Cytokine Storm 
      and Oxidative Stress and Therapeutic Effects.
LID - 10.3390/ijms242316610 [doi]
LID - 16610
AB  - Cellular homeostasis is lost or becomes dysfunctional during septic shock due to 
      the activation of the inflammatory response and the deregulation of oxidative 
      stress. Antioxidant therapy administered alongside standard treatment could 
      restore this lost homeostasis. We included 131 patients with septic shock who 
      were treated with standard treatment and vitamin C (Vit C), vitamin E (Vit E), 
      N-acetylcysteine (NAC), or melatonin (MT), in a randomized trial. Organ damage 
      quantified by Sequential Organ Failure Assessment (SOFA) score, and we determined 
      levels of Interleukins (IL) IL1beta, Tumor necrosis factor alpha (TNFalpha), IL-6, 
      monocyte chemoattractant protein-1 (MCP-1), Transforming growth factor B (TGFbeta), 
      IL-4, IL-10, IL-12, and Interferon-gamma (IFNgamma). The SOFA score decreased in patients 
      treated with Vit C, NAC, and MT. Patients treated with MT had statistically 
      significantly reduced of IL-6, IL-8, MCP-1, and IL-10 levels. Lipid peroxidation, 
      Nitrates and nitrites (NO(3)(-) and NO(2)(-)), glutathione reductase, and 
      superoxide dismutase decreased after treatment with Vit C, Vit E, NAC, and MT. 
      The levels of thiols recovered with the use of Vit E, and all patients treated 
      with antioxidants maintained their selenium levels, in contrast with controls (p 
      = 0.04). The findings regarding oxidative stress markers and cytokines after 
      treatment with antioxidants allow us to consider to future the combined use of 
      antioxidants in a randomized clinical trial with a larger sample to demonstrate 
      the reproducibility of these beneficial effects.
FAU - Perez-Torres, Israel
AU  - Perez-Torres I
AUID- ORCID: 0000-0001-6510-2954
AD  - Cardiovascular Biomedicine Department, Instituto Nacional de Cardiologia Ignacio 
      Chavez, Juan Badiano No. 1, Col. Seccion XVI, Mexico City 14380, Mexico.
FAU - Aisa-Alvarez, Alfredo
AU  - Aisa-Alvarez A
AUID- ORCID: 0000-0002-9211-3904
AD  - Critical Care Department, American British Cowdray (ABC) Medical Center, PAI ABC 
      Sur 136 No. 116, Col. las Americas, Mexico City 01120, Mexico.
FAU - Casarez-Alvarado, Sergio
AU  - Casarez-Alvarado S
AD  - Immunology Department, Instituto Nacional de Cardiologia Ignacio Chavez, Juan 
      Badiano No. 1, Col. Seccion XVI, Mexico City 14380, Mexico.
FAU - Borrayo, Gabriela
AU  - Borrayo G
AD  - Instituto Mexicano del Seguro Social, Direccion de Prestaciones Medicas 
      Coordinacion de Innovacion en Salud, Ciudad de Mexico 06700, Mexico.
FAU - Marquez-Velasco, Ricardo
AU  - Marquez-Velasco R
AD  - Immunology Department, Instituto Nacional de Cardiologia Ignacio Chavez, Juan 
      Badiano No. 1, Col. Seccion XVI, Mexico City 14380, Mexico.
FAU - Guarner-Lans, Veronica
AU  - Guarner-Lans V
AUID- ORCID: 0000-0002-2655-7590
AD  - Physiology Department, Instituto Nacional de Cardiologia Ignacio Chavez, Juan 
      Badiano No. 1, Col. Seccion XVI, Mexico City 14380, Mexico.
FAU - Manzano-Pech, Linaloe
AU  - Manzano-Pech L
AD  - Cardiovascular Biomedicine Department, Instituto Nacional de Cardiologia Ignacio 
      Chavez, Juan Badiano No. 1, Col. Seccion XVI, Mexico City 14380, Mexico.
FAU - Cruz-Soto, Randall
AU  - Cruz-Soto R
AD  - Immunology Department, Instituto Nacional de Cardiologia Ignacio Chavez, Juan 
      Badiano No. 1, Col. Seccion XVI, Mexico City 14380, Mexico.
FAU - Gonzalez-Marcos, Omar
AU  - Gonzalez-Marcos O
AD  - Critical Care Department, American British Cowdray (ABC) Medical Center, PAI ABC 
      Sur 136 No. 116, Col. las Americas, Mexico City 01120, Mexico.
FAU - Fuentevilla-Alvarez, Giovanny
AU  - Fuentevilla-Alvarez G
AUID- ORCID: 0000-0002-1819-8444
AD  - Physiology Department, Instituto Nacional de Cardiologia Ignacio Chavez, Juan 
      Badiano No. 1, Col. Seccion XVI, Mexico City 14380, Mexico.
FAU - Gamboa, Ricardo
AU  - Gamboa R
AUID- ORCID: 0000-0001-9102-4240
AD  - Physiology Department, Instituto Nacional de Cardiologia Ignacio Chavez, Juan 
      Badiano No. 1, Col. Seccion XVI, Mexico City 14380, Mexico.
FAU - Saucedo-Orozco, Huitizilihuitl
AU  - Saucedo-Orozco H
AUID- ORCID: 0000-0002-4156-6364
AD  - Cardioneumology Department, Specialty Hospital, National Medical Center "La 
      Raza", Mexico City 02990, Mexico.
FAU - Franco-Granillo, Juvenal
AU  - Franco-Granillo J
AD  - Critical Care Department, American British Cowdray (ABC) Medical Center, PAI ABC 
      Sur 136 No. 116, Col. las Americas, Mexico City 01120, Mexico.
FAU - Soto, Maria Elena
AU  - Soto ME
AUID- ORCID: 0000-0003-1332-2888
AD  - Immunology Department, Instituto Nacional de Cardiologia Ignacio Chavez, Juan 
      Badiano No. 1, Col. Seccion XVI, Mexico City 14380, Mexico.
AD  - Research Direction Instituto Nacional de Cardiologia Ignacio Chavez, Juan Badiano 
      No. 1, Col. Seccion XVI, Mexico City 14380, Mexico.
AD  - Cardiovascular Line in American British Cowdray (ABC) Medical Center, PAI ABC Sur 
      136 No. 116, Col. Las Americas, Mexico City 01120, Mexico.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20231122
PL  - Switzerland
TA  - Int J Mol Sci
JT  - International journal of molecular sciences
JID - 101092791
RN  - 0 (Antioxidants)
RN  - 0 (Interleukin-6)
RN  - 130068-27-8 (Interleukin-10)
RN  - PQ6CK8PD0R (Ascorbic Acid)
RN  - 1406-18-4 (Vitamin E)
RN  - WYQ7N0BPYC (Acetylcysteine)
RN  - JL5DK93RCL (Melatonin)
RN  - 0 (Adjuvants, Immunologic)
SB  - IM
MH  - Humans
MH  - Antioxidants/therapeutic use
MH  - Interleukin-6
MH  - Cytokine Release Syndrome/drug therapy
MH  - Interleukin-10
MH  - *Shock, Septic/drug therapy
MH  - Reproducibility of Results
MH  - Oxidative Stress
MH  - Ascorbic Acid/therapeutic use
MH  - Vitamin E/therapeutic use
MH  - Acetylcysteine/therapeutic use
MH  - *Melatonin/therapeutic use
MH  - Adjuvants, Immunologic/therapeutic use
PMC - PMC10706209
OTO - NOTNLM
OT  - antioxidants
OT  - cytokines
OT  - melatonin
OT  - septic shock
COIS- The authors declare no conflict of interest.
EDAT- 2023/12/09 10:43
MHDA- 2023/12/17 09:46
PMCR- 2023/11/22
CRDT- 2023/12/09 01:13
PHST- 2023/10/10 00:00 [received]
PHST- 2023/11/14 00:00 [revised]
PHST- 2023/11/18 00:00 [accepted]
PHST- 2023/12/17 09:46 [medline]
PHST- 2023/12/09 10:43 [pubmed]
PHST- 2023/12/09 01:13 [entrez]
PHST- 2023/11/22 00:00 [pmc-release]
AID - ijms242316610 [pii]
AID - ijms-24-16610 [pii]
AID - 10.3390/ijms242316610 [doi]
PST - epublish
SO  - Int J Mol Sci. 2023 Nov 22;24(23):16610. doi: 10.3390/ijms242316610.