The systemic inflammatory response reflects the non-specific clinical expression of a profound activation of the body’s immune responsive elements. Immune activation and immune suppression coexist in the blood of patients with severe sepsis. It is their interaction and the resultant host parenchymal responses that ultimately define the course of sepsis. Importantly, neither profound immune activation (pro-inflammatory) or immune suppression (anti-inflammatory) characterize the dominant process. Rather, there is a combined low grade pro-inflammatory state associated with an immune hyporesponsiveness that defines the usual immunologic state of the patient with severe sepsis.
Keywordsinflammatory response PMN leukocyte activation inflammatory mediators.
Unable to display preview. Download preview PDF.
- Bone R. C., Balk R. A., Cerra F. B., Dellinger R. P., Fein A. M., Knaus W. A., Schein R. M. and Sibbald W. J. (1992): Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP SCCM Consensus Conference Committee. Chest, 101, 1644–1655.PubMedCrossRefGoogle Scholar
- Brandtzaeg P., Osnes L., Ovstebo R., Joo G. B., Westvik A. B. and Kierulf P. (1996): Net inflammatory capacity of human septic shock plasma evaluated by a monocyte-based target cell assay: identification of interleukin-10 as a major functional deactivator of human monocytes. J. Exp. Med., 184, 51–60.PubMedCrossRefGoogle Scholar
- Conlan J. W. and North R. J. (1992): Monoclonal antibody NIMP-R10 directed against the CD1lb chain of the type 3 complement receptor can substitute for monoclonal antibody 5C6 to exacerbate listeriosis by preventing the focusing of myelomonocytic cells at infectious foci in the liver. J. Leukoc. Biol., 52, 130–132.PubMedGoogle Scholar
- Etzioni A. (1994): Adhesion molecule deficiencies and their clinical significance. Cell Adhesion Commun., 2, 257–260.Google Scholar
- Goris R. J., Tee B. T, Nuytinck J. K. and Gimbrere J. S. (1985): Multiple-organ failure. Generalized autodestructive inflammation? Arch. Surg., 120, 1109–1115.Google Scholar
- Knaus W. A., Harrell F. E., Fisher C. J., Wagner D. P., Opal S. M., Sadoff J. C., Draper E. A., Walawander C. A., Conboy K. and Grasela T. H. (1993): The clinical evaluation of new drugs for sepsis. A prospective study design based on survival analysis. J. Am. Med. Assoc., 270, 1233–1241.CrossRefGoogle Scholar
- Rosenbloom A. J., Pinsky M. R., Bryant J. L., Shin A., Tran T. and Whiteside T. (1995): Leukocyte activation in the peripheral blood of patients with cirrhosis of the liver and SIRS. Correlation with serum interleukin-6 levels and organ dysfunction. J. Am. Med. Assoc., 274, 58–65.CrossRefGoogle Scholar
- Singer I. I., Scott S., Kawka D. W. and Kazazis D. M. (1989): Adhesomes: specific granules containing receptors for laminin, C3bi fibrinogen, fibronectin, and vitronectin in human polymorphonuclear leukocytes and monocytes. J. Cell. Biol., 109 3169–3182.Google Scholar