[Mediators and their antagonists in shock therapy].
The list of shock mediators currently comprises more than 150 candidates. A careful analysis using the criteria of Koch-Dale together with decision trees for exclusion of bias revealed that only histamine, C5a, beta-endorphin, tumor necrosis factor (TNF) thromboxane B2, platelet-activating factor (PAF), and oxygen free radicals are shown to be causally associated with shock symptoms. Although experimental studies with inhibitors of these mediators were convincing, there is still a lack of evidence under clinical conditions (exception histamine: anaphylactic shock). Combinations of antagonists against different causal mediators are the most promising future approaches.
Neugebauer
E
E
Biochemische und Experimentelle Abteilung, Universität zu Köln, Bundesrepublik Deutschland.
Leuchleuthner
A
A
Dietrich
A
A
Saad
S
S
Rixen
D
D
D000209:Acute-Phase Proteins / Q000502:physiology*; D000210:Acute-Phase Reaction / Q000503:physiopathology* / Q000628:therapy*; D003422:Critical Care / Q000379:methods*; D006801:Humans; D012773:Shock, Surgical / Q000503:physiopathology* / Q000628:therapy*
D000209:Acute-Phase Proteins
Mediatoren und ihre Antagonisten in der Schocktherapie.