A Review on The Protective Effects of Metformin in Sepsis-Induced Organ Failure


Fatima Ismail Hassan, M.Sc, 1Tina Didari, M.Sc, 1Fazlullah Khan, M.Sc, 1Kamal Niaz, Ph.D, 1Mojtaba Mojtahedzadeh, Pharm.D., 1,2,3Mohammad Abdollahi, Ph.D., 1,2,*
1. The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran
2. Department of Toxicology and Pharmacology, Tehran University of Medical Sciences, Tehran, Iran
3. Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
1. The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran
2. Department of Toxicology and Pharmacology, Tehran University of Medical Sciences, Tehran, Iran
3. Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
*Corresponding Address: The Institute of Pharmaceutical Sciences (TIPS) Tehran University of Medical Sciences Tehran Iran Email:mohammad@tums.ac.ir
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Ismail Hassan Fatima, Didari Tina, Khan Fazlullah, Niaz Kamal, Mojtahedzadeh Mojtaba, Abdollahi Mohammad. A Review on The Protective Effects of Metformin in Sepsis-Induced Organ Failure. Cell J. 2020; 21(4): 363-370.

Abstract

Despite advances in sepsis management, it remains a major intensive-care-unit (ICU) concern. From new prospective, positive effects of metformin, such as anti-oxidant and anti-inflammatory properties are considered potentially beneficial properties for management of septic patients. This article reviewed the potential ameliorative effects of metformin in sepsis-induced organ failure. Information were retrieved from PubMed, Scopus, Embase, and Google Scholar. Multi-organ damage, oxidative stress, inflammatory cytokine stimulation, and altered circulation are hallmarks of sepsis. Metformin exerts its effect via adenosine monophosphate-activated protein kinase (AMPK) activation. It improves sepsis-induced organ failure by inhibiting the production of reactive oxygen species (ROS) and pro-inflammatory cytokines, preventing the activation of transcription factors related to inflammation, decreasing neutrophil accumulation/infiltration, and also maintaining mitochondrial membrane potential. Studies reported the safety of metformin therapeutic doses, with no evidence of lactic acidosis, in septic patients.