Role of SIRT1 in sepsis-induced encephalopathy: molecular targets for
future therapies
Abstract
Sepsis is a life-threatening organ dysfunction that results from
dysregulated host response to infection. Multiple organ system
dysfunction syndromes are prevalent among septic patients and are
essential hallmarks of sepsis diagnosis. These syndromes involve failure
of the pulmonary, hepatic, circulatory, renal, gastrointestinal and
central nervous systems. Neurological dysfunction is part of this
syndrome and has gained research attention recently [1]. Sepsis
induces neuroinflammation, BBB disruption, cerebral hypoxia, neuronal
mitochondrial dysfunction and cell death causing sepsis-associated
encephalopathy (SAE). These pathological consequences lead to short- and
long-term neurobehavioral deficits. Till now there is no specific
treatment that directly improves SAE and its associated behavioral
impairments. In this review, we discuss the underlying mechanisms of
sepsis-induced brain injury with a focus on the latest progress
regarding neuroprotective effects of SIRT1 (silent mating type
information regulation-2 homologue-1). SIRT1 is an NAD+-dependent class
III protein deacetylase. It is able to modulate multiple downstream
signals (including NF-κB, HMGB, AMPK, PGC1α and FoxO) which are involved
in the development of SAE by its deacetylation activity. There are
multiple recent studies showing the neuroprotective effects of SIRT1 in
neuroinflammation related diseases. The proposed neuroprotective action
of SIRT1 is meant to bring a promising therapeutic strategy for managing
SAE and ameliorating its related behavioural deficits.