Cytokine inhibitors for sepsis and septic shock |
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| Affiliation: | 1. Division of Hematology/Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Physicians Office Building, Suite 3116-CB#7305, 170 Manning Drive, Chapel Hill, NC 27599, USA;2. Division of Hematology/Oncology, Department of Medicine, East Carolina University, 600 Moye Boulevard, Brody 3E127, Greenville, NC 27834, USA;1. Division of Radiation Oncology, University of South Alabama Mitchell Cancer Institute, 1660 Spring Hill Avenue, Mobile, AL 36604, USA;2. Department of Radiation Oncology, Vanderbilt University Medical Center, 2220 Pierce Avenue, Preston Research Building B-1003, Nashville, TN 37232, USA |
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| Abstract: | Lipopolysaccharide and other bacterial products stimulate the immune cells of the host to elicit secondary inflammatory mediators, including cytokines. The 2 primary proinflammatory cytokines elicited in septic shock are tumor necrosis factor (TNF) and interleukin-1 (IL-1). Because of the importance of these cytokines in the biologic response to sepsis, they stand out as potential targets for adjunctive therapies of sepsis. This review focuses on therapies designed to inhibit the responses of TNF and IL-1, including studies in animals and humans evaluating TNF monoclonal antibodies, TNF receptor fusion proteins, IL-1 receptor antagonists, IL-1 receptor antibodies, and phosphodiesterase inhibitors. In general, the human trials have been disappointing in comparison with corresponding animal studies. As of yet, no cytokine inhibitor therapy that significantly decreases mortality in patients with severe sepsis or septic shock has been found. Copyright © 2001 by W.B. Saunders Company |
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