Portal de Periódicos da CAPES

Cytokine modulation in sepsis and septic shock

2002; Taylor & Francis; Volume: 11; Issue: 8 Linguagem: Inglês

10.1517/13543784.11.8.1061

1744-7658

Sergio Zanotti, Anand Kumar, Aseem Kumar,

Apelin-related biomedical research

Sepsis and septic shock are a major cause of morbidity and mortality in patients admitted to the intensive care unit. Since the introduction of antibiotic therapy, the mortality associated with sepsis has remained within the 30 – 50% range. Sepsis constitutes the systemic response to infection. This response encompasses both pro-inflammatory and anti-inflammatory phases that are marked by the sequential generation of pro- and anti-inflammatory cytokines. Among the most important pro-inflammatory cytokines are TNF-α and IL-1β. The pro-inflammatory effects of such cytokines are inhibited by soluble receptors/receptor antagonists and anti-inflammatory cytokines including IL-10 and transforming growth factor-β. Modulation of the activity of both pro- and anti-inflammatory cytokines to improve outcome in patients with sepsis has been subject of multiple clinical studies. This review will examine clinical trials evaluating several strategies for blocking or attenuating TNF-α and IL-1β activity. This review will also survey the current state of experimental therapies involving IL-10, transforming growth factor-β, granulocyte colony-stimulating factor and IFN-γ. Finally, newer developments related to less known cytokines such as macrophage migration inhibitory factor and high mobility group 1 protein will be evaluated.