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Review

Persistence of Lipoproteins and Cholesterol Alterations after Sepsis: Implication for Atherosclerosis Progression

1
Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA 19104, USA
2
Department of Neurology, University of Pennsylvania, Philadelphia, PA 19104, USA
3
Leonard Davis Institute of Healthcare Economics, Philadelphia, PA 19104, USA
Academic Editors: Vladimir Tesar and Vladimir Trifonov
Int. J. Mol. Sci. 2021, 22(19), 10517; https://doi.org/10.3390/ijms221910517
Received: 19 August 2021 / Revised: 22 September 2021 / Accepted: 26 September 2021 / Published: 29 September 2021
(This article belongs to the Special Issue Atherosclerosis: From Molecular Biology to Therapeutic Perspective)
(1) Background: Sepsis is one of the most common critical care illnesses with increasing survivorship. The quality of life in sepsis survivors is adversely affected by several co-morbidities, including increased incidence of dementia, stroke, cardiac disease and at least temporary deterioration in cognitive dysfunction. One of the potential explanations for their progression is the persistence of lipid profile abnormalities induced during acute sepsis into recovery, resulting in acceleration of atherosclerosis. (2) Methods: This is a targeted review of the abnormalities in the long-term lipid profile abnormalities after sepsis; (3) Results: There is a well-established body of evidence demonstrating acute alteration in lipid profile (HDL-c ↓↓, LDL-C -c ↓↓). In contrast, a limited number of studies demonstrated depression of HDL-c levels with a concomitant increase in LDL-C -c in the wake of sepsis. VLDL-C -c and Lp(a) remained unaltered in few studies as well. Apolipoprotein A1 was altered in survivors suggesting abnormalities in lipoprotein metabolism concomitant to overall lipoprotein abnormalities. However, most of the studies were limited to a four-month follow-up and patient groups were relatively small. Only one study looked at the atherosclerosis progression in sepsis survivors using clinical correlates, demonstrating an acceleration of plaque formation in the aorta, and a large metanalysis suggested an increase in the risk of stroke or acute coronary event between 3% to 9% in sepsis survivors. (4) Conclusions: The limited evidence suggests an emergence and persistence of the proatherogenic lipid profile in sepsis survivors that potentially contributes, along with other factors, to the clinical sequel of atherosclerosis. View Full-Text
Keywords: sepsis; septic shock; lipid profile; apolipoproteins; atherosclerosis; neurodegeneration; long-term outcome; allostasis sepsis; septic shock; lipid profile; apolipoproteins; atherosclerosis; neurodegeneration; long-term outcome; allostasis
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MDPI and ACS Style

Laudanski, K. Persistence of Lipoproteins and Cholesterol Alterations after Sepsis: Implication for Atherosclerosis Progression. Int. J. Mol. Sci. 2021, 22, 10517. https://doi.org/10.3390/ijms221910517

AMA Style

Laudanski K. Persistence of Lipoproteins and Cholesterol Alterations after Sepsis: Implication for Atherosclerosis Progression. International Journal of Molecular Sciences. 2021; 22(19):10517. https://doi.org/10.3390/ijms221910517

Chicago/Turabian Style

Laudanski, Krzysztof. 2021. "Persistence of Lipoproteins and Cholesterol Alterations after Sepsis: Implication for Atherosclerosis Progression" International Journal of Molecular Sciences 22, no. 19: 10517. https://doi.org/10.3390/ijms221910517

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