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The production and regulation of mtROS involve multiple molecular mechanisms, including VDAC1\u2010mediated mitochondrial impairment and the STK3\/KEAP1\/Nrf2 signalling pathway. Once generated, mtROS contribute to cellular damage through dual effects on the nitric oxide\u2010lipid metabolic axis and complex interactions with ferroptosis. The pathological impact of mtROS is further amplified by mitochondria\u2010endoplasmic reticulum interactions involving the DUSP1\/PHB2 pathway. Critically, mtROS drive immune\u2010related organ damage in sepsis by modulating the immune microenvironment, characterised by dynamic changes in cytokine storms, local cardiac immune cell infiltration, and aberrant activation of inflammatory signalling pathways. The SIRT3\u2010SOD2 axis plays a key regulatory role in this process, as cardiac\u2010specific overexpression of SOD2 improves heart function by controlling mtROS levels. Together, this review interconnected mechanisms establish mtROS as a central hub linking mitochondrial dysfunction, immune dysregulation, and myocardial injury in SICM, suggesting that targeting mtROS and its regulatory pathways represents a promising therapeutic strategy.<\/jats:p>","DOI":"10.1111\/1440-1681.70122","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T02:44:43Z","timestamp":1774838683000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Interaction of\n                    <scp>mtROS<\/scp>\n                    \u2010Immune\u2010Inflammatory Vicious Cycle Activation in Sepsis\u2010Induced Cardiomyopathy"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3396-9437","authenticated-orcid":false,"given":"Yu","family":"Wang","sequence":"first","affiliation":[{"name":"Key Laboratory of Medical Electrophysiology, Ministry of Education and 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