Corticosteroid-binding globulin (CBG): spatiotemporal distribution of cortisol in sepsis.
Trends Endocrinol Metab
; 34(3): 181-190, 2023 03.
Article
em En
| MEDLINE
| ID: mdl-36681594
ABSTRACT
Corticosteroid-binding globulin (CBG) is a 50-60 kDa circulating glycoprotein with high affinity for cortisol. CBG is adapted for sepsis; its cortisol binding is reduced reversibly by pyrexia and acidaemia, and reduced irreversibly by neutrophil elastase (NE) cleavage, converting high cortisol-binding affinity CBG to a low affinity form. These characteristics allow for the targeted delivery of immunomodulatory cortisol to tissues at the time and body site where cortisol is required in sepsis and septic shock. In addition, high titer inflammatory cytokines in sepsis suppress CBG hepatic synthesis, increasing the serum free cortisol fraction. Recent clinical studies have highlighted the importance of CBG in septic shock, with CBG deficiency independently associated with mortality.
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Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Choque Séptico
/
Sepse
Limite:
Humans
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article