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Anti-cytokine Therapy in Critical Illness: Is There a Role?

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Management of Dysregulated Immune Response in the Critically Ill

Part of the book series: Lessons from the ICU ((LEICU))

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Abstract

The acute innate immune response to infection and tissue trauma is affected and regulated through the release of a large number of inducible proteins known as cytokines. Normally present in the circulation at very low levels, cytokine expression and release are induced in response to danger signals detected by pattern recognition receptors on innate immune cells. The dynamic nature of the cytokine response and the ease with which it can be shown to impact survival in animal models of acute inflammation have made these mediators attractive candidates for the targeted therapy of sepsis. The results of their manipulation in critical illness have been disappointing, though many have emerged as promising treatments for chronic inflammatory disorders such as rheumatoid arthritis. This chapter reviews the biology of the cytokine response and its potential as a therapeutic target. Building on insights derived from studies of cytokine manipulation in COVID-19, it discusses the reasons for an apparent lack of efficacy in sepsis and identifies priorities to overcome these.

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Authors and Affiliations

  1. Department of Surgery, University of Toronto, Toronto, Ontario, Canada

    John C. Marshall

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  1. John C. Marshall
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Correspondence to John C. Marshall .

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Editors and Affiliations

  1. Department of Anaesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary

    Zsolt Molnar

  2. Department of Critical Care, King’s College London, Guy’s & St Thomas’ NHS Foundation Trust, London, UK

    Marlies Ostermann

  3. The Queen’s Medical Research Institute Edinburgh BioQuarter, Centre for Inflammation Research, University of Edinburgh, Edinburgh, UK

    Manu Shankar-Hari

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Marshall, J.C. (2023). Anti-cytokine Therapy in Critical Illness: Is There a Role?. In: Molnar, Z., Ostermann, M., Shankar-Hari, M. (eds) Management of Dysregulated Immune Response in the Critically Ill. Lessons from the ICU. Springer, Cham. https://doi.org/10.1007/978-3-031-17572-5_17

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  • DOI: https://doi.org/10.1007/978-3-031-17572-5_17

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