{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T12:24:23Z","timestamp":1791289463671,"version":"4.3.0"},"reference-count":323,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Universidad Aut\u00f3noma de Guadalajara"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cells"],"abstract":"<jats:p>Shock is a life-threatening condition characterized by inadequate tissue perfusion leading to systemic hypoxia and metabolic failure. Ischemia\/reperfusion (I\/R) injury exacerbates shock progression through oxidative stress and immune dysregulation, contributing to multi-organ dysfunction. This narrative review synthesizes current evidence on the interplay between I\/R injury, oxidative stress, and immune modulation in shock states. We analyze the classification of shock, its progression, and the molecular pathways involved in ischemic adaptation, inflammatory responses, and oxidative injury. Shock pathophysiology is driven by systemic ischemia, triggering adaptive responses such as hypoxia-inducible factor (HIF) signaling and metabolic reprogramming. However, prolonged hypoxia leads to mitochondrial dysfunction, increased reactive oxygen species (ROS) and reactive nitrogen species (RNS) production, and immune activation. The transition from systemic inflammatory response syndrome (SIRS) to compensatory anti-inflammatory response syndrome (CARS) contributes to immune imbalance, further aggravating tissue damage. Dysregulated immune checkpoint pathways, including CTLA-4 and PD-1, fail to suppress excessive inflammation, exacerbating oxidative injury and immune exhaustion. The intricate relationship between oxidative stress, ischemia\/reperfusion injury, and immune dysregulation in shock states highlights potential therapeutic targets. Strategies aimed at modulating redox homeostasis, controlling immune responses, and mitigating I\/R damage may improve patient outcomes. Future research should focus on novel interventions that restore immune balance while preventing excessive oxidative injury.<\/jats:p>","DOI":"10.3390\/cells14110808","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T09:22:41Z","timestamp":1748596961000},"page":"808","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Role of Ischemia\/Reperfusion and Oxidative Stress in Shock State"],"prefix":"10.3390","volume":"14","author":[{"given":"Yarielis Ivette","family":"V\u00e1zquez-Gal\u00e1n","sequence":"first","affiliation":[{"name":"School of Medicine International Program, Universidad Aut\u00f3noma de Guadalajara, Av. Patria 1201, Zapopan 45129, Jalisco, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8751-2994","authenticated-orcid":false,"given":"Sandra","family":"Guzm\u00e1n-Silahua","sequence":"additional","affiliation":[{"name":"School of Medicine International Program, Universidad Aut\u00f3noma de Guadalajara, Av. Patria 1201, Zapopan 45129, Jalisco, Mexico"},{"name":"Unidad de Investigaci\u00f3n Epidemiol\u00f3gica y en Servicios de Salud, Centro M\u00e9dico Nacional de Occidente \u00d3rgano de Operaci\u00f3n Administrativa Desconcentrada Jalisco, Instituto Mexicano del Seguro Social, Guadalajara 44329, Jalisco, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter \u00c1ngel","family":"Trujillo-Rangel","sequence":"additional","affiliation":[{"name":"Departamento de Aparatos y Sistemas II, Decanato de Ciencias de la Salud, Universidad Aut\u00f3noma de Guadalajara, Av. Patria 1201, Lomas del Valle, Zapopan 45129, Jalisco, Mexico"},{"name":"Departamento de Ciencias Biom\u00e9dicas, Centro Universitario de Tonal\u00e1, Universidad de Guadalajara, Tonal\u00e1 45425, Jalisco, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9489-2481","authenticated-orcid":false,"given":"Sim\u00f3n Quetzalcoatl","family":"Rodr\u00edguez-Lara","sequence":"additional","affiliation":[{"name":"School of Medicine International Program, Universidad Aut\u00f3noma de Guadalajara, Av. 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