The role of hormones in the pathogenesis and treatment mechanisms of delirium in ICU: The past, the present, and the future

• Published in: The Journal of steroid biochemistry and molecular biology Vol. 233; p. 106356
• Main Authors: Cao, Yuchun, Song, Yuwei, Ding, Yuan, Ni, Jiayuan, Zhu, Bin, Shen, Jianqin, Miao, Liying
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.10.2023
• Subjects: Delirium; Glucocorticoid; ICU; Non-steroid hormones; Psychiatric disorders; CRP; Delirium; BBB; Glucocorticoid; mTOR; NMDA; GC; AChE; BDNF; MR; Ach; MT; IGF-1; GR; IL-6; Non-steroid hormones; TrkB; TNF-α; DEX; NE; CRH; GsK-3; HPA; ICU; GRE; 5-HT; DA; LTD; TLR4; Psychiatric disorders
• ISSN: 0960-0760; 1879-1220
• DOI: 10.1016/j.jsbmb.2023.106356

Delirium is an acute brain dysfunction. As one of the common psychiatric disorders in ICU, it can seriously affect the prognosis of patients. Hormones are important messenger substances found in the human body that help to regulate and maintain the function and metabolism of various tissues and organs. They are also one of the most commonly used drugs in clinical practice. Recent evidences suggest that aberrant swings in cortisol and non-cortisol hormones might induce severe cognitive impairment, eventually leading to delirium. However, the role of hormones in the pathogenesis of delirium still remains controversial. This article reviews the recent research on risk factors of delirium and the association between several types of hormones and cognitive dysfunction. These mechanisms are expected to offer novel ideas and clinical relevance for the treatment and prevention of delirium. •The mechanisms of glucocorticoid-induced delirium are thoroughly discussed.•The highest incidence of delirium is in the ICU with multiple kinds of risk factors.•Hormone therapy may be an option for preventing and treating delirium.