Oxidative stress and gene expression in sepsis

Jamie MacDonald, Helen Frances Galley, Nigel Robert Webster

Research output: Contribution to journalLiterature reviewpeer-review

422 Citations (Scopus)


Dysregulation of the immuno-inflammatory response, as seen in sepsis, may culminate in host cell and organ damage. Lipopolysaccharide from Gram-negative bacterial cell walls induces gene activation and subsequent inflammatory mediator expression. Gene activation is regulated by a number of transcription factors at the nuclear level, of which nuclear factor kappaB appears to have a central role. The redox (reduction-oxidation) cellular balance is important for normal cellular function, including transcription factor regulation. In sepsis, a state of severe oxidative stress is encountered, with host endogenous antioxidant defences overcome. This has implications for cellular function and the regulation of gene expression. This review gives an overview of the mechanisms by which transcription factor activation and inflammatory mediator overexpression occur in sepsis, together with the events surrounding the state of oxidative stress encountered and the effects on the host's antioxidant defences. The effect of oxidative stress on transcription factor regulation is considered, together with the role of antioxidant repletion in transcription factor activation and in sepsis in general. Other interventions that may modulate transcription factor activation are also highlighted.

Original languageEnglish
Pages (from-to)221-232
Number of pages11
JournalBritish Journal of Anaesthesia
Issue number2
Publication statusPublished - 2003


  • infection, sepsis
  • metabolism
  • critically ill patients
  • acetyl-L-cysteine
  • Inflammatory response
  • tumor-necrosis-factor
  • xanthine-oxidase activity
  • detectable iron present
  • multiple organ failure
  • tert-butylnitrone PBN
  • septic shock


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