ORIGINAL RESEARCH article
Front. Cell. Infect. Microbiol.
Sec. Clinical Infectious Diseases
Volume 15 - 2025 | doi: 10.3389/fcimb.2025.1607586
This article is part of the Research TopicMolecular mechanisms and clinical studies of multi-organ dysfunction in sepsis associated with pathogenic microbial infectionView all 13 articles
A multi-omics study of magnesium sulfate to improve prognosis in sepsis-related encephalopathy: integrating clinical data-driven network pharmacology
Provisionally accepted
- 1Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences Tongji Shanxi Hospital, Taiyuan, 030032, China, Taiyuan, China
- 2Basic Medical College, Shanxi Medical University, Taiyuan, 030032, China., Taiyuan, China
- 3Department of Neurology, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China, Taiyuan, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Sepsis-associated encephalopathy (SAE) constitutes a significant neurological manifestation of sepsis, characterized by high mortality rates and posing a critical threat to patient outcomes. Magnesium sulfate has multiple effects in the nervous system, including neuroprotection, sedation, anticonvulsant activity, enhanced neuroplasticity, anti -inflammation and promotion of nerve repair. It can regulate calcium homeostasis, exert antioxidant effects, and reduce the release of inflammatory factors, thereby alleviating neuronal damage and neurological deficits. This study integrated MIMIC-IV database and network pharmacology to explore magnesium sulfate's neuroprotective mechanisms and clinical impact on SAE outcomes.Retrospective data from 4,650 SAE patients in MIMIC-IV 3.0 were analyzed. Propensity score matching balanced covariates. Cox models and Kaplan-Meier curves evaluated magnesium sulfate's association with 28-day all-cause mortality (ACM). Network pharmacology identified magnesium sulfate's core targets and pathways.4183 patients (89.96%) received magnesium sulfate during ICU, while 467 (10.04%) did not receive.The 28-day ACM in patients with SAE was 11.05%. After propensity score matching participants with and without magnesium sulfate administration had 28-day ACM of 17.29% and 30.42%, respectively (P < 0.001). Magnesium sulfate administration was associated with reduced 28-day ACM. Subgroup analysis revealed this association differed in several stratification. Network pharmacology revealed magnesium sulfate targets TNF, IL6, IL1B and CXCL8, modulating pathways including inflammatory response, immune regulation, and cellular stress.Magnesium sulfate use correlates with improved SAE survival, particularly those with comorbid chronic obstructive pulmonary disease and acute kidney injury, and using vasoconstrictors, likely through multi-target modulation of inflammatory response and immune regulation. Prospective studies are needed for validation.
Keywords: Magnesium Sulfate, SAE, Mortality, MIMIC-IV database, Network Pharmacology
Received: 07 Apr 2025; Accepted: 22 May 2025.
Copyright: © 2025 Kong, Tai, Chen, Zhang, Ji, Feng, Shi and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Liang Shi, Basic Medical College, Shanxi Medical University, Taiyuan, 030032, China., Taiyuan, China
Hao Chen, Department of Neurology, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China, Taiyuan, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.