title: [Humoral mediators in the pathophysiology of organ dysfunction in sepsis].
abstract: It is recognized that various humoral mediators, especially inflammatory cytokines such as tumor necrosis-factor-alpha and interleukin (IL)-1 beta, play a key role in the pathophysiology of septic shock and organ dysfunction following severe infection. We have recently begun to employ a rapid measurement system that allows us to measure blood IL-6 levels within 30 min using a chemiluminescent enzyme immunoassay. IL-6 blood levels reflect well the activation of the cytokine cascade and correlated well with the severity of patient's, condition. The ratio of simultaneously measured IL-6 blood levels in peripheral and pulmonary arteries is useful to identify the site responsible for cytokine production. Early initiation of PMMA-CHDF as a cytokine modulator of septic shock results in improved recovery from shock and in improved outcome. Genetic analysis of cytokine-related genes revealed a high frequency of a specific genotype in patients who have extremely high IL-6 blood levels. Screening of patients at high risk of hypercytokinemia with the specific genotype would enable appropriate treatments and contribute to future tailor-made medicine.
authors.affiliation: Department of Emergency and Critical Care Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Shigeto
authors.initials: S
authors.lastname: Oda
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hirasawa
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Shiga
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Matsuda
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Ueno
authors.forename: Masataka
authors.initials: M
authors.lastname: Nakamura
authors.forename: Eizou
authors.initials: E
authors.lastname: Watanabe
mesh_terms: D016207:Cytokines / Q000502:physiology*; D006440:Hemofiltration; D006801:Humans; D015850:Interleukin-6 / Q000096:biosynthesis; D009102:Multiple Organ Failure / Q000503:physiopathology*; D019904:Polymethyl Methacrylate; D018805:Sepsis / Q000503:physiopathology* / Q000517:prevention & control
chemical_list: D016207:Cytokines; D015850:Interleukin-6; D019904:Polymethyl Methacrylate