Apoptosis in the Resolution of Systemic Inflammation
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Admission to a contemporary ICU is precipitated by a heterogeneous group of disease processes, yet the final common pathway to death is strikingly similar . Fully 80% of all ICU deaths occur in association with the multiple organ dysfunction syndrome (MODS) , a poorly understood process characterized by the development of progressive physiologic dysfunction in organ systems initially unaffected by the primary disease process. Activation of a host inflammatory response by infection, injury, or ischemia, invariably proceeds the development of MODS . The proximate causes of organ injury are not bacterial products, but the same endogenous host-derived mediators of inflammation that are responsible for containing an infectious challenge and initiating the process of tissue repair. MODS can be conceptualized as the consequence of an overly activated or inappropriately prolonged systemic inflammatory response, therefore an understanding of the mechanisms underlying the resolution of inflammation is important to the development of clinical strategies to prevent the syndrome.
KeywordsSystemic Inflammatory Response Syndrome Tumor Necrosis Factor Receptor Multiple Organ Dysfunction Syndrome Staphylococcal Enterotoxin Neutrophil Apoptosis
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