The biological functions of cholesterol are diverse, ranging from cell membrane integrity, cell membrane signaling, and immunity to the synthesis of steroid and sex hormones, vitamin D, bile acids, and oxysterols. Multiple studies have demonstrated hypocholesterolemia in sepsis, the degree of which is an excellent prognosticator of poor outcomes. However, the clinical significance of hypocholesterolemia has been largely unrecognized. We undertook a detailed review of the biological roles of cholesterol, the impact of sepsis, its reliability as a prognosticator in sepsis, and the potential utility of cholesterol as a treatment. Sepsis affects cholesterol synthesis, transport, and metabolism. This likely impacts its biological functions, including immunity, hormone and vitamin production, and cell membrane receptor sensitivity. Early preclinical studies show promise for cholesterol as a pleiotropic therapeutic agent. Hypocholesterolemia is a frequent condition in sepsis and an important early prognosticator. Low plasma concentrations are associated with wider changes in cholesterol metabolism and its functional roles, and these appear to play a significant role in sepsis pathophysiology. The therapeutic impact of cholesterol elevation warrants further investigation.

Daniel A. Hofmaenner

Anna Kleyman

Adrian Press

Michael Bauer

Mervyn Singer

American Journal of Respiratory and Critical Care Medicine

《美国呼吸与重症监护医学杂志》专注于人类生物学和疾病，以及有助于了解影响呼吸系统和危重病人的疾病的病理生理学和治疗的动物和体外研究。主要以细胞和分子生物学为基础的论文发表在配套期刊《美国呼吸细胞和分子生物学杂志》上。该杂志还寻求以多种形式发表有关感兴趣领域的临床试验和优秀评论文章。最先进的评论是一篇论文，通常涵盖一个广泛的领域，将基准研究带到床边。较短的评论以重症监护观点或肺部观点发表。这些通常集中在更有限的领域，并就特定过程的护理提出一致意见。简明临床评论提供了基于证据的文献综合，这些文献涉及对肺、重症监护和睡眠医学实践具有根本重要性的主题。为该领域提供进步或不寻常贡献的图像以“肺、重症监护、睡眠医学和科学中的图像”的形式发布。

The American Journal of Respiratory and Critical Care Medicine focuses on human biology and diseases, as well as animal and in vitro studies that help understand the pathophysiology and treatment of diseases affecting the respiratory system and critically ill patients. Papers primarily based on cellular and molecular biology are published in the companion journal, the American Journal of Respiratory Cell and Molecular Biology. The journal also seeks to publish clinical trials and outstanding review articles in various formats related to areas of interest. State-of-the-art reviews are comprehensive papers that cover a broad field, bridging foundational research to bedside applications. Shorter reviews are published from the perspectives of critical care or pulmonary medicine, focusing on more limited areas and providing consensus on the care of specific processes. Concise clinical reviews offer evidence-based literature syntheses on topics of fundamental importance to pulmonary, critical care, and sleep medicine practice. Images that provide advances or unusual contributions to the field are published in the form of 'Images in Lung, Critical Care, Sleep Medicine, and Science.'

《美国呼吸与重症监护医学杂志》专注于人类生物学和疾病，以及有助于理解影响呼吸系统和危重病患者的疾病的病理生理学和治疗的动物及体外研究。主要以细胞和分子生物学为基础的论文会发表在配套期刊《美国呼吸细胞和分子生物学杂志》上。该杂志还欢迎以多种形式发表有关感兴趣领域的临床试验和优秀评论文章。最先进的评论通常涵盖广泛的领域，将基准研究与临床实践相结合。较短的评论则从重症监护或肺部的角度出发，集中在更具体的领域，并就特定过程的护理提出一致意见。简明临床评论提供基于证据的文献综述，涉及对肺、重症监护和睡眠医学实践至关重要的主题。此外，提供该领域进展或不寻常贡献的图像将以“肺、重症监护、睡眠医学和科学中的图像”的形式发布。

The Many Roles of Cholesterol in Sepsis: A Review

Early preclinical studies show promise for cholesterol as a pleiotropic therapeutic agent and low plasma levels are associated with wider changes in cholesterol metabolism and its functional roles, and these appear to play a significant role in sepsis pathophysiology.

Category	Quartile
医学	1
医学, 危重病医学	1
医学, 呼吸系统	1

The Many Roles of Cholesterol in Sepsis: A Review

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Category	Quartile
RESPIRATORY SYSTEM	1