title: Targeting cytokines as a treatment for patients with sepsis: A lost cause or a strategy still worthy of pursuit?
abstract: Despite often knowing the aetiology of sepsis and its clinical course there has not been the anticipated advances in treatment strategies. Cytokines are influential mediators of immune/inflammatory reactions and in patients with sepsis high circulating levels are implicated in the onset and perpetuation of organ failure. Antagonising the activities of pro-inflammatory cytokines enhances survival in animal models of sepsis but, so far, such a therapeutic strategy has not improved patient outcome. This article addresses the questions of why encouraging laboratory findings have failed to be translated into successful treatments of critically ill patients and whether modifying cytokine activity still remains a promising avenue for therapeutic advance in severe sepsis. In pursuing this task we have selected reports that we believe provide an incisive, critical and balanced view of the topic.
authors.affiliation: Intensive Care Unit, Guy's and St.Thomas' Hospitals, London, UK; Division of Asthma Allergy and Lung Biology, King's College London, UK. Electronic address: alun.brown@kcl.ac.uk.
authors.forename: K Alun
authors.initials: KA
authors.lastname: Brown
authors.affiliation: The Whittington Hospital, London, UK.
authors.forename: Geraint A
authors.initials: GA
authors.lastname: Brown
authors.affiliation: Intensive Care Unit, Guy's and St.Thomas' Hospitals, London, UK; Division of Asthma Allergy and Lung Biology, King's College London, UK.
authors.forename: Sion M
authors.initials: SM
authors.lastname: Lewis
authors.affiliation: Intensive Care Unit, Guy's and St.Thomas' Hospitals, London, UK; Division of Asthma Allergy and Lung Biology, King's College London, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Beale
authors.affiliation: Intensive Care Unit, Guy's and St.Thomas' Hospitals, London, UK; Division of Asthma Allergy and Lung Biology, King's College London, UK.
authors.forename: David F
authors.initials: DF
authors.lastname: Treacher
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D016207:Cytokines / Q000378:metabolism*; D004195:Disease Models, Animal; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D058990:Molecular Targeted Therapy; D019899:Paracrine Communication; D018805:Sepsis / Q000276:immunology / Q000628:therapy*
chemical_list: D000893:Anti-Inflammatory Agents; D016207:Cytokines
keywords: Cytokines; Immunopathology; Sepsis; Therapy