Cytokines as Mediators in the Pathogenesis of Septic Shock

  • C. A. Dinarello
Part of the Current Topics in Microbiology and Immunology book series (CT MICROBIOLOGY, volume 216)


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 production of these cytokines is initiated by the organisms themselves (phagocytosis) or by soluble products of the organisms. For example, the lipopolysaccharide endotoxins (LPS) of gram-negative bacteria, the protein exotoxins of gram-positive bacteria, and the cell-wall glycopeptides such as teichoic acids and muramyl peptides. Of course, LPS is by far the most potent soluble product of bacteria which induces cytokine production, and therefore most information about cytokine induction is derived from studies using LPS in vitro and in vivo. However, it is important to recognize that the cytokine production in septic shock is neither specific nor unique. 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 (acute hepatitis and pancreatitis) initiate the same cytokine cascade and result in both systemic and local inflammatory processes.


Tumor Necrosis Factor Septic Shock Soluble Receptor Tumor Necrosis Factor Gene Expression 
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Copyright information

© Springer-Verlag Berlin Heidelberg 1996

Authors and Affiliations

  • C. A. Dinarello
    • 1
  1. 1.Department of Medicine, Division of Infectious DiseasesUniversity of Colorado, Health Science CenterDenverUSA

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