{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:48:48Z","timestamp":1787028528271,"version":"build-2736575974"},"reference-count":133,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T00:00:00Z","timestamp":1700611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Centro Medico A.B.C. Observatorio Project","award":["ABC number 18-19"],"award-info":[{"award-number":["ABC number 18-19"]}]},{"name":"Instituto Nacional de Cardiologia Ignacio Chavez","award":["ABC number 18-19"],"award-info":[{"award-number":["ABC number 18-19"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Cellular homeostasis is lost or becomes dysfunctional during septic shock due to the activation of the inflammatory response and the deregulation of oxidative stress. Antioxidant therapy administered alongside standard treatment could restore this lost homeostasis. We included 131 patients with septic shock who were treated with standard treatment and vitamin C (Vit C), vitamin E (Vit E), N-acetylcysteine (NAC), or melatonin (MT), in a randomized trial. Organ damage quantified by Sequential Organ Failure Assessment (SOFA) score, and we determined levels of Interleukins (IL) IL1\u03b2, Tumor necrosis factor alpha (TNF\u03b1), IL-6, monocyte chemoattractant protein-1 (MCP-1), Transforming growth factor B (TGF\u03b2), IL-4, IL-10, IL-12, and Interferon-\u03b3 (IFN\u03b3). The SOFA score decreased in patients treated with Vit C, NAC, and MT. Patients treated with MT had statistically significantly reduced of IL-6, IL-8, MCP-1, and IL-10 levels. Lipid peroxidation, Nitrates and nitrites (NO3\u2212 and NO2\u2212), glutathione reductase, and superoxide dismutase decreased after treatment with Vit C, Vit E, NAC, and MT. The levels of thiols recovered with the use of Vit E, and all patients treated with antioxidants maintained their selenium levels, in contrast with controls (p = 0.04). The findings regarding oxidative stress markers and cytokines after treatment with antioxidants allow us to consider to future the combined use of antioxidants in a randomized clinical trial with a larger sample to demonstrate the reproducibility of these beneficial effects.<\/jats:p>","DOI":"10.3390\/ijms242316610","type":"journal-article","created":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T04:21:27Z","timestamp":1700626887000},"page":"16610","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Impact of Treatment with Antioxidants as an Adjuvant to Standard Therapy in Patients with Septic Shock: Analysis of the Correlation between Cytokine Storm and Oxidative Stress and Therapeutic Effects"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6510-2954","authenticated-orcid":false,"given":"Israel","family":"P\u00e9rez-Torres","sequence":"first","affiliation":[{"name":"Cardiovascular Biomedicine Department, Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Juan Badiano No. 1, Col. Secci\u00f3n XVI, Mexico City 14380, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9211-3904","authenticated-orcid":false,"given":"Alfredo","family":"Aisa-\u00c1lvarez","sequence":"additional","affiliation":[{"name":"Critical Care Department, American British Cowdray (ABC) Medical Center, PAI ABC Sur 136 No. 116, Col. las Am\u00e9ricas, Mexico City 01120, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Casarez-Alvarado","sequence":"additional","affiliation":[{"name":"Immunology Department, Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Juan Badiano No. 1, Col. Secci\u00f3n XVI, Mexico City 14380, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Borrayo","sequence":"additional","affiliation":[{"name":"Instituto Mexicano del Seguro Social, Direcci\u00f3n de Prestaciones M\u00e9dicas Coordinaci\u00f3n de Innovaci\u00f3n en Salud, Ciudad de M\u00e9xico 06700, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"M\u00e1rquez-Velasco","sequence":"additional","affiliation":[{"name":"Immunology Department, Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Juan Badiano No. 1, Col. Secci\u00f3n XVI, Mexico City 14380, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2655-7590","authenticated-orcid":false,"given":"Ver\u00f3nica","family":"Guarner-Lans","sequence":"additional","affiliation":[{"name":"Physiology Department, Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Juan Badiano No. 1, Col. Secci\u00f3n XVI, Mexico City 14380, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linaloe","family":"Manzano-Pech","sequence":"additional","affiliation":[{"name":"Cardiovascular Biomedicine Department, Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Juan Badiano No. 1, Col. Secci\u00f3n XVI, Mexico City 14380, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randall","family":"Cruz-Soto","sequence":"additional","affiliation":[{"name":"Immunology Department, Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Juan Badiano No. 1, Col. 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Secci\u00f3n XVI, Mexico City 14380, Mexico"},{"name":"Research Direction Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Juan Badiano No. 1, Col. Secci\u00f3n XVI, Mexico City 14380, Mexico"},{"name":"Cardiovascular Line in American British Cowdray (ABC) Medical Center, PAI ABC Sur 136 No. 116, Col. 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