Epigenetics is an emerging frontier of biology, with the potential for deciphering the intricate molecular and transcriptional cellular programs, therefore contributing to explain the pathological evolution of sepsis, one of the most elusive syndromes in medicine. The evolution of sepsis depends not only on the pathogen which originated the infection but also on the genetic and epigenetic background of the host. Short-term mortality of sepsis and septic shock is high, being considered a public health concern worldwide. Immunosuppression is the predominant driving force for morbidity and mortality in late deaths and long-term deaths of survivors from a sepsis episode. In this regard, apoptosis of immune cells and complex epigenetic reprogramming in immune and progenitor cells may contribute to the immunoparalysis observed in post-septic patients, who are prone to the apparition of new, opportunistic infections. Here, we review the literature and expose the most relevant results which explain the epigenetic programs contributing to the progression of sepsis. Furthermore, we revisit the role of circulating histones in the pathogenesis of sepsis and septic shock and finally we discuss about the therapeutic potential of epigenetic drugs in the treatment of sepsis.
Jose Luis Garcia Gimenez, Nieves Edurne Carbonell, Carlos Roma Mateo, Eva Garcia López, Lorena Palacios, Lorena Peiro Chova, Ester Berenguer, Carla Giménez Garzo, Federico V Pallardó, and Jose Blanquer
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