Receptor Blocking Agents: Why Did They Fail?
The wide array of cardiorespiratory and metabolic derangements commonly observed in sepsis is caused by the production and the release by the immunocompetent and the endothelial cells of a number of mediators deriving from the interaction between the infecting agent and the host , including the tumour necrosis factor (TNF), the platelet activating factor (PAF), an ever-increasing number of Interleukins (IL), the endothelin, the arachidonic acid derivates and many others. The same substances are also implicated in the development of the Systemic Inflammatory Response Syndrome (SIRS), which, however, is primed by non-infectious stimuli, such as acute pancreatitis, ruptured aortic aneurysms etc. [21. Similarly to other biological systems (e.g. the coagulative cascade), the secretion of many if not all of these mediators is accompanied by the simultaneous release of substances with inhibitory properties, theleologically aimed to down-regulate the inflammatory process. Basically, these agents act by binding and inactivating the circulating septic mediators and/or by occupying their receptors on the surface of the target cells, thus making them unavailable for the active mediators .
KeywordsSeptic Shock Systemic Inflammatory Response Syndrome Septic Patient Soluble Receptor Sepsis Syndrome
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