Oxytocin, en endogen neuropeptid med potential att minska mortaliteten vid sepsis? : En litteraturstudie

Sammanfattning: Sepsis is a relatively unknown, but common, condition with high mortality. Sepsis is defined as life-threatening organ dysfunction caused by an excessive immune response in the host as a result of an infection. Sepsis can be caused by many different pathogens, giving a varying symptomatic profile and arise via many different routes of exposure. The pathogenesis of sepsis is very complex and not yet fully understood, but hyperactivation of mainly the innate immune system with consequences such as complement activation, cytokine storm, secretion of reactive oxygen species and endothelial influence are considered central mechanisms that further lead to organ dysfunction with septic shock and possible death. The cause of infection in sepsis can often be treated with early-acting broad-spectrum antibiotics, but there is a lack of treatment for the host response and the hyperactivation of the immune system.  Oxytocin is an endogenous neuropeptide that acts on receptors throughout the body including the nervous system and in certain immune cells. Oxytocin has long been known for its role in childbirth and breastfeeding, where it is also used clinically, and for its importance in behavioral functions such as learning and bonding. Recent research has shown a broader effect of oxytocin such as antioxidant and anti-inflammatory substance. These findings have opened up a new perspective on oxytocin and its potential uses, where treatment for sepsis-induced hyperactivation of the immune system is a suggestion.  The aim of this work is to evaluate, based on the published studies, whether exogenous oxytocin can be used therapeutically in sepsis to limit hyperactivation of the immune system and reduce the risk of organ dysfunction with septic shock and possible death.  The method used in the work is literature search via the database PubMed and further analysis and discussion of six preclinical research articles. All analyzed studies were sepsis induced in rodents, and oxytocin was administered as potential treatment.     The results showed exogenous administration of oxytocin in rodents had the effect of antioxidant, anti-inflammatory substance, tissue protective peptide and that via vagal cholinergic stimulation it can to some extent restore physical parameters affected by sepsis induction such as heart rate, heart rate variation and respiration. Oxytocin also had positive effects on the general condition in these preclinical studies. In conclusion, exogenous administration of oxytocin in sepsis seems to have beneficial effects that can reduce the hyperactivation of the immune system in sepsis and contribute to reduced mortality in the same.