REACTIVE OXYGEN SPECIES IN THE CELLULAR PATHOPHYSIOLOGY OF SHOCK

Reactive oxygen species (ROS) mediate the fine balance between cellula r physiology and pathophysiology, Accordingly it is not surprising tha t cellular redox homeostasis is disrupted by shock events related to i schemia-reperfusion and inflammation. ROS may initiate as well as ampl ify the shock cellular insult in a number of ways which include import ant contributions to inflammation as well as lytic and apoptotic cell death. In addition, ROS in the setting of shock represent important an tecedents to cellular proliferation, differentiation, and adaptation b y virtue of altered transcription and translation of antioxidant enzym es, stress proteins, and a variety of cytokines, It is likely that an eventual important biochemical therapeutic goal in the setting of shoc k will involve re-establishing cellular redox homeostasis not only to ensure cellular structural integrity, but also to re-establish normal secondary cellular signal transduction mechanisms.