Cytokines in Severe Sepsis and Septic Shock

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Springer Science & Business Media, 1998 - Medical - 369 pages
This book deals with the central role of cytokines in the generalized inflammatory response of the host as the consequence of severe infection/endotoxin action. International specialists cover several aspects in 20 chapters starting with the agents responsible (endotoxin, superantigens) and recognition during cytokine induction. Further chapters deal with the signal transduction cascade, its modulation due to sex or genetic polymorphism, and the possibilities and problems in detection (including surrogate markers). Major targets of actions are covered in the chapters on coagulation-/fibrinolysis, adherence molecules, vasoactive factors, apoptosis and metabolism. As not all actions of cytokines are beneficial, several chapters deal with the prevention of induction, modulation of the cytokine generation or scavenging cytokines including gene therapy approaches. Models are necessary for obtaining pathophysiological information and for testing therapeutic approaches, and thus all chapters deal with experimental models as well as clinical trials. The reasons why these have failed so far are the subject of the final chapter.
 

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Contents

Endotoxin as an inducer of cytokines
3
Acute lung inflammation in septic shock of the cytokine release induced by bacterial superantigens
15
Lipopolysaccharide signaling pathways and their role in the development of the systemic inflammatory response syndrome
37
effect of sex nutritional factors and age on immunity following shock and sepsis
57
cytokine polymorphisms
79
Diagnostic
93
Possibilities and problems of cytokine measurements
95
Soluble TNF receptors
121
Its role in the systemic inflammatory response syndrome and the involvement of cytokines
213
Importance of cytokine metabolism for malnutrition catabo lism and endocrinological state in sepsis
227
Therapy
245
Endotoxin scavengers as a therapeutic strategy for sepsis
247
Interfering with the production of cytokines in sepsis
261
Neutralizing antibodies and receptor constructs
285
Immunomodulation following shock and sepsis
295
Gene therapy an alternative approach for anticytokine therapies
315

Relevance of surrogate tests in intensive care patients or Heisenberg at the ICU
133
Actions selected events
149
Nitric oxide and endothelin1 in circulatory shock involving cytokines
151
Multistep processes in neutrophil homotypic aggregation and tissue injury
173
Cytokines coagulation and fibrinolysis
199
Challenges of preclinical models
333
Challenges of clinical trial design
349
Index
363
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Page 331 - Feigner, PL, Gadek, TR, Holm, M., Roman, R., Chan, HW, Wenz, M., Northrop, JP, Ringold, GM, and Danielsen, M.

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