Abstract
During septic shock the host produces several proinflammatory cytokines which have been implicated as playing a critical role in the pathogenesis of the disease. The cytokines which contribute to pathological changes in septic shock are not unique to infection. Multiple trauma, ischemia-reperfusion injury, acute transplant rejection, antigen-specific immune responses, and various acute inflammatory states (pancreatitis) initiate the same cytokine cascade and result in both systemic and local inflammatory processes. However, septic shock is a special case, since no other disease is associated with such high mortality, despite our ability to provide patients with appropriate antibiotics and supportive therapy. Gene deletion, neutralizing antibody studies, and specific receptor blockade of cytokines have been shown to have a pivotal role in the pathogenesis of septic shock, at least in animal studies. Normally, cytokine response is regulated by the intricate network of proinflammatory and anti-inflammatory mediators. The inflammatory response is kept in check by down-regulating production and counteracting the effects of cytokines already produced.
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Zabel, P., Bahrami, S. (1999). Interfering with the production of cytokines in sepsis. In: Redl, H., Schlag, G. (eds) Cytokines in Severe Sepsis and Septic Shock. Progress in Inflammation Research. Birkhäuser, Basel. https://doi.org/10.1007/978-3-0348-8755-7_15
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