Tumour necrosis factor in surgical illness.
TNF is a multipurpose molecule which works alongside other cytokines to stimulate and coordinate immune and inflammatory responses to antigenic challenges. It is extremely well conserved throughout all mammal species, and obviously confers considerable survival advantage. There are circumstances, however, in which TNF itself can be a source of tissue injury. This occurs in septic shock when the magnitude of the host response is overwhelming. TNF also initiates the energy substrate mobilization required to meet the heightened fuel demands associated with immunological, inflammatory and wound-healing activities. In chronic infection and malignancy this may lead to severe depletion of host tissues with its own attendant morbidity and mortality. At present our understanding of the host response is expanding rapidly. The challenge for the future will be to manipulate this response selectively, to maximize its influence on the disease while minimizing its negative impact on the host.
Department of Surgery, University of Otago, Dunedin, New Zealand.
J L
JL
McCall
B R
BR
Parry
D000818:Animals; D000970:Antineoplastic Agents; D001685:Biological Factors / Q000502:physiology; D016207:Cytokines; D006801:Humans; D007111:Immunity, Cellular; D007239:Infections / Q000276:immunology; D009369:Neoplasms / Q000276:immunology; D012772:Shock, Septic / Q000503:physiopathology; D014181:Transplantation Immunology; D014409:Tumor Necrosis Factor-alpha / Q000494:pharmacology / Q000502:physiology*; D014947:Wounds and Injuries / Q000276:immunology
D000970:Antineoplastic Agents; D001685:Biological Factors; D016207:Cytokines; D014409:Tumor Necrosis Factor-alpha