Cytokine Neutralization: An Overview
Part of the Update in Intensive Care Medicine book series (volume 31)
An excessive inflammatory response accompanies the initial stages of severe infection and appears to contribute to organ system failure and death in this setting [1, 2, 3]. A number of immunomodulatory therapies aimed at decreasing the dysregulated inflammatory response have been examined in patients with sepsis (Table 1). Despite initially encouraging results with many of these approaches in Phase II clinical trials, larger Phase III studies have not demonstrated benefit. In contrast to the lack of effect of immunomodulatory agents in sepsis, therapies directed against specific pro-inflammatory cytokines, such as tumor necrosis factor (TNF)-α or interleukin (IL)-1,have produced remarkable clinical response in diseases such as rheumatoid arthritis and Crohn’s disease [4, 5, 6].
KeywordsSeptic Shock Severe Sepsis Septic Shock Patient Immunomodulatory Agent Organ System Failure
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
Unable to display preview. Download preview PDF.
- 21.Fisher CJ Jr., Slotman GJ, Opal SM, et al (1994) Initial evaluation of human recombinant interleukin-1 receptor antagonist in the treatment of sepsis syndrome: a randomized, open-label, placebo-controlled multicenter trial. The IL-1RA Sepsis Syndrome Study Group. Crit Care Med 22:12–21PubMedGoogle Scholar
- 22.Fisher CJ Jr, Dhainaut JF, Opal SM, et al (1994) Recombinant human interleukin 1 receptor antagonist in the treatment of patients with sepsis syndrome. Results from a randomized, double-bUnd, placebo-controlled trial. Phase III rhIL-1ra Sepsis Syndrome Study Group. JAMA 271:1836–1843PubMedCrossRefGoogle Scholar
- 25.Hinshaw LB, Tekamp-Olson P, Chang AC, et al (1990) Survival of primates in LDioo septic shock following therapy with antibody to tumor necrosis factor (TNF). Cire Shock 30:279–292Google Scholar
- 30.Reinhart K, Wiegand-Lohnert C, Grimminger F, et al (1996) Assessment of the safety and efficacy of the monoclonal anti-tumor necrosis factor antibody-fragment, MAK 195F, in patients with sepsis and septic shock: A multicenter, randomized, placebo-controlled, dose-ranging study Crit Care Med 24:733–742PubMedCrossRefGoogle Scholar
© Springer-Verlag Berlin Heidelberg 2002