ReviewCritical care (London, England)2004
Science review: mechanisms of impaired adrenal function in sepsis and molecular actions of glucocorticoids.
Review in Critical care (London, England), 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 148 citations in OpenAlex.
- Transcriptome modulation by hydrocortisone in severe burn shock: ancillary analysis of a prospective randomized trial.Critical care (London, England) · 2017Trial
- Gluco- and mineralocorticoid biological effects of a 7-day treatment with low doses of hydrocortisone and fludrocortisone in septic shock.Intensive care medicine · 2012Trial
- A clinician's guide to corticosteroid therapy in pneumonia and critical illness: agent selection, dosing, monitoring, and interactions.Pneumonia (Nathan Qld.) · 2026Review
- Endocrine Effects of Arginine-Vasopressin After Pediatric Cardiac Surgery.Pediatric cardiology · 2026Article
- Cardiac Endocrine Function and Hormonal Interplay in Pediatrics: From Development to Clinical Implications.Biomedicines · 2025Review
- The ACTH test fails to diagnose adrenal insufficiency and augments cytokine production in sepsis.JCI insight · 2025Article
- The Role of SR-BI in sepsis: leveraging mechanistic insights to advance precision steroid therapy.Frontiers in immunology · 2025Review
- A narrative review of the pathophysiology of sepsis in sub-Saharan Africa: Exploring the potential for corticosteroid therapy.PLOS global public health · 2025Review
- C5a Induces Inflammatory Signaling and Apoptosis in PC12 Cells through C5aR-Dependent Signaling: A Potential Mechanism for Adrenal Damage in Sepsis.International journal of molecular sciences · 2024Article
- Recent Data about the Use of Corticosteroids in Sepsis-Review of Recent Literature.Biomedicines · 2024Review
- Relative adrenal insufficiency is a risk factor and endotype of sepsis - A proof-of-concept study to support a precision medicine approach to guide glucocorticoid therapy for sepsis.Frontiers in immunology · 2022Article
- Dexamethasone for Severe COVID-19: How Does It Work at Cellular and Molecular Levels?International journal of molecular sciences · 2021Review
- Adrenal insufficiency in neonates undergoing cardiopulmonary bypass and postoperative hypothalamic-pituitary-adrenal function after prophylactic glucocorticoids.Journal of perinatology : official journal of the California Perinatal Association · 2019Observational
- Protective Effect of CasperomeFrontiers in pharmacology · 2018Article
- Corticosteroid Therapy Benefits Septic Mice With Adrenal Insufficiency But Harms Septic Mice Without Adrenal Insufficiency.Critical care medicine · 2015Article
- Resistance of LPS-activated bone marrow derived macrophages to apoptosis mediated by dexamethasone.Scientific reports · 2014Article
- Pediatric sepsis: challenges and adjunctive therapies.Critical care clinics · 2013Review
- Endocrine emergencies in critically ill patients: Challenges in diagnosis and management.Indian journal of endocrinology and metabolism · 2012Article
- Steroidogenesis in the adrenal dysfunction of critical illness: impact of etomidate.Critical care (London, England) · 2012Observational
- The glucocorticoid-induced leucine zipper (gilz/Tsc22d3-2) gene locus plays a crucial role in male fertility.Molecular endocrinology (Baltimore, Md.) · 2012Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This review describes current knowledge on the mechanisms that underlie glucocorticoid insufficiency in sepsis and the molecular action of glucocorticoids. In patients with severe sepsis, numerous factors predispose to glucocorticoid insufficiency, including drugs, coagulation disorders and inflammatory mediators. These factors may compromise the hypothalamic-pituitary axis (i.e. secondary adrenal insufficiency) or the adrenal glands (i.e. primary adrenal failure), or may impair glucocorticoid access to target cells (i.e. peripheral tissue resistance). Irreversible anatomical damages to the hypothalamus, pituitary, or adrenal glands rarely occur. Conversely, transient functional impairment in hormone synthesis may be a common complication of severe sepsis. Glucocorticoids interact with a specific cytosolic glucocorticoid receptor, which undergoes conformational changes, sheds heat shock proteins and translocates to the nucleus. Glucocorticoids may also interact with membrane binding sites at the surface of the cells. The molecular action of glucocorticoids results in genomic and nongenomic effects. Direct and indirect transcriptional and post-transcriptional effects related to the cytosolic glucocorticoid receptor account for the genomic effects. Nongenomic effects are probably subsequent to cytosolic interaction between the glucocorticoid receptor and proteins, or to interaction between glucocorticoids and specific membrane binding sites.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.