Advancements on the alleviation of sepsis through alkaloids derived from plants: From the past to the current.

Sepsis refers to a syndrome characterized by an imbalance in the systemic immune response triggered by infection. Its pathogenesis is intricate. In the early stage, it is typified by a severe systemic inflammatory response. In the later stage, the body undergoes immunosuppression, resulting in immune paralysis and exacerbating multi-organ damage. Plant-derived alkaloids have garnered increasing scientific interest for their roles in mitigating inflammation and facilitating organ function recovery. These compounds exert their effects by inhibiting multiple inflammatory signaling pathways, thereby down-regulating the pro-inflammatory cytokines. Additionally, they alleviate oxidative stress-induced cellular damage and mitochondrial dysfunction, ultimately contributing to the reduction of apoptosis. Furthermore, alkaloids have exhibited notable safety and efficacy during clinical applications, substantially enhancing the prognosis of patients suffering from septic shock. In this review, a bibliometric analysis was initially performed on the literature regarding the associations between alkaloids and various organs damaged by sepsis in recent years. Subsequently, preclinical and clinical research advancements were comprehensively reviewed, focusing on how plant-derived alkaloids safeguard against sepsis-induced dysfunctions in the lungs, liver, kidneys, stomach, heart, intestines, and brain. These protective effects are achieved through multiple mechanisms, including anti-inflammatory, anti-oxidative stress, and anti-apoptotic actions. We herein provided recent advancements in research for subsequent progression and implementation of plant-derived alkaloids.