[Sepsis: infection and systemic inflammatory response].
Sepsis represents an important infectious process with systemic manifestation. The incidence of sepsis is continuously increasing. This epidemiologic trend reflects the aging population, increasing number of chronically ill patients and invasiveness of the modern medicine. An increasing resistance of infectious agents causing sepsis plays also a role. The progress in diagnosis and treatment of sepsis, which was achieved in last decades, influenced prognosis of the disease only slightly. This fact is due to our inadequate understanding of sepsis pathogenesis. An important role in the sepsis pathogenesis is played by systemic inflammatory response, which may cause tissue damage leading to the organ failure. This reaction is controlled by anti-inflammatory response, which may be exaggerated leading to increased susceptibility to secondary infections or reduced ability to combat primary infection. The knowledge obtained from experimental studies could not been utilized, because of short therapeutic window of new immunotherapies. As an example is a failure of clinical study with monoclonal antibody against TNF-a. Thus, the search for new clinically effective therapeutic agents is aimed at pathogenetic mechanisms activated in longer time frame after the primary insult. Currently, out of drugs modulating the already known immunopathophysiological mechanisms of sepsis corticosteroids and activated protein C are used.
Holub
M
M
III. klinika infekcnich a tropických nemocí 1, LF UK a FN Na Bulovce, Praha. michal.holub@lf1.cuni.cz
D006801:Humans; D018805:Sepsis / Q000175:diagnosis / Q000503:physiopathology; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis / Q000503:physiopathology