title: [Cytokine imbalance in critically ill patients: SIRS and CARS].
abstract: It remains difficult to treat severely ill patients, especially those who have sepsis and subsequent multiple organ dysfunction syndrome. We propose the hypothesis that the pathophysiology in the sequential sepsis and multiple organ dysfunction syndrome may be strongly related to the imbalance between inflammatory cytokines and antiinflammatory cytokines induced for the host defense to active neutrophils and endothelial cells. Thus we attempted to develop cytokine modulation therapy to normalize the cytokine balance in the host defense system. In this review, we elucidate the relationship between cytokine imbalance and SIRS/CARS in patients with severe burn injury. Furthermore, we examine the possible usage of G-CSF to amplify neutrophil function, and clarify the reasons why various innovative therapies against sepsis have failed.
authors.affiliation: Department of Traumatology and Critical Care Medicine, Kyorin University School of Medicine, Mitaka, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Murata
authors.forename: M
authors.initials: M
authors.lastname: Kikuchi
authors.forename: S
authors.initials: S
authors.lastname: Mishima
authors.forename: S
authors.initials: S
authors.lastname: Sakaki
authors.forename: H
authors.initials: H
authors.lastname: Goto
authors.forename: T
authors.initials: T
authors.lastname: Matsuoka
authors.forename: H
authors.initials: H
authors.lastname: Tanaka
authors.forename: T
authors.initials: T
authors.lastname: Yukioka
authors.forename: S
authors.initials: S
authors.lastname: Shimazaki
mesh_terms: D016638:Critical Illness; D016207:Cytokines / Q000502:physiology*; D006801:Humans; D007249:Inflammation / Q000097:blood
chemical_list: D016207:Cytokines