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. 2021 Dec 21;12(1):1. doi: 10.3390/metabo12010001

Figure 4.

Figure 4

The alterations of glycolysis-related metabolites and tricarboxylic acid (TCA) cycle metabolites for sepsis diagnosis (Table 1), septic shock diagnosis (Table 2), prognostication of sepsis (Table 3), prognostication of septic shock (Table 4), and monitoring the treatment response (Table 5). A down-sided triangle (▼) represents a decreased level, whereas an up-sided triangle (▲) represents the opposite. The alterations of several sugars are found, including glucose, sucrose, mannose, and myo-inositol. Glucose, a main energy source for human cells, converts to pyruvate and acetyl-CoA, respectively, before entering the TCA cycle. In addition, acetylcarnitine (C2 carnitine) can feed via acetyl-CoA as well. Another anaerobic metabolite, lactate, are found to be increased in sepsis patients with poor prognosis. Citrate is the initial metabolite of the TCA cycle, which turns into isocitrate, α-ketoglutarate, succinyl-CoA, succinate, fumarate, malate, and oxaloacetate, respectively. The increases in TCA cycle-related metabolites represent an augmentation of aerobic metabolism during sepsis, which can promote oxidative phosphorylation and reactive oxygen species (ROS) production. An increase in the ROS level may be one of the potential mechanisms mediating sepsis-induced mitochondrial dysfunction.