title: [Concept of SIRS and severe acute pancreatitis].
abstract: Acute pancreatitis is a potentially fatal disease, the severity of which ranges from a mild edematous form to a severe necrotizing form. Most patients develop systemic inflammatory response syndrome (SIRS), which is induced by proinflammatory cytokines. The cytokine production can be induced by activation of Toll-like receptor. The breakdown products of the pancreatic and peripancreatic tissues by proteases might be the agonists. Cytokines are supposed to be produced as a biological defense system. However, cytokines may often evoke organ failure and/or immunosuppressive state, if they would be produced excessively. To express this complicated pathologic condition, Ogawa proposed a concept of LISIS(local inflammation-induced systemic immunosuppression syndrome). We have to pay attention to such aspects in the management of this disease.
authors.affiliation: Department of Gastroenterological Surgery, Kumamoto University.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Hirota
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sugita
authors.forename: Keisuke
authors.initials: K
authors.lastname: Maeda
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ichibara
authors.forename: Michio
authors.initials: M
authors.lastname: Ogawa
mesh_terms: D000208:Acute Disease; D000818:Animals; D016207:Cytokines / Q000009:adverse effects / Q000378:metabolism / Q000502:physiology; D006801:Humans; D007108:Immune Tolerance; D018836:Inflammation Mediators; D008070:Lipopolysaccharides / Q000009:adverse effects; D008562:Membrane Glycoproteins / Q000378:metabolism / Q000502:physiology; D009102:Multiple Organ Failure / Q000209:etiology; D010195:Pancreatitis / Q000150:complications*; D011956:Receptors, Cell Surface / Q000378:metabolism / Q000502:physiology; D012720:Severity of Illness Index; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology*; D051193:Toll-Like Receptors
chemical_list: D016207:Cytokines; D018836:Inflammation Mediators; D008070:Lipopolysaccharides; D008562:Membrane Glycoproteins; D011956:Receptors, Cell Surface; D051193:Toll-Like Receptors