Sepsis - Pro-Inflammatory and Anti-Inflammatory Responses

Description

Sepsis is a serious condition that is associated with high mortality despite advanced modern medical treatment. Recent years have witnessed novel paradigms describing host responses in sepsis. In particular, the delicate balance between pro- and anti-inflammatory reactions has been subject to intense research. This volume in the book series ‘Contributions to Microbiology’ presents the state of the art in this rapidly expanding field of research. Leading international experts have contributed with reviews on the most relevant topics in the field such as clinical aspects, pathways of sepsis and pro- and anti-inflammatory mechanisms as well as their regulation. The book will be a valuable source of up-to-date information for clinicians, microbiologists, immunologists, and students with an interest in the complex regulation of host responses during microbial sepsis.

Informations

• Publié par: S. Karger AG
• Date de parution: 31 mai 2011
• Nombre de lectures: 0
• EAN13: 9783805597111
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

Sepsis - Pro-Inflammatory and Anti-Inflammatory Responses
Contributions to Microbiology
Vol.17
Series Editors
Axel Schmidt     Düsseldorf
Heiko Herwald     Lund
 
Sepsis - Pro-Inflammatory and Anti-Inflammatory Responses
Good, Bad or Ugly?
Volume Editors
Heiko Herwald     Lund
Arne Egesten     Lund
24 figures, 3 in color, and 14 tables, 2011
Contributions to Microbiology
formerly ‘Concepts in Immunopathology’ and ‘Contributions to Microbiology and Immunology’
_________________________
__________________________
Heiko Herwald, PhD Department of Clinical Sciences Division of Infection Medicine Biomedical Center, Lund University Tornavägen 10 SE-221 84 Lund (Sweden)
Arne Egesten, MD, PhD Department of Clinical Sciences Division of Respiratory Medicine and Allergology Biomedical Center, Lund University Tornavägen 10 SE-221 84 Lund (Sweden)
Library of Congress Cataloging-in-Publication Data
Sepsis: pro-inflammatory and anti-inflammatory responses: good, bad or ugly? / volume editors, Heiko Herwald, Arne Egesten.
p.;cm. -- (Contributions to microbiology, ISSN 1420-9519 ;v.17)
Includes bibliographical references and indexes.
ISBN 978-3-8055-9710-4 (hard cover: alk. paper) -- ISBN 978-3-8055-9711-1 (e-ISBN)
1. Septicemia-Immunological aspects. 2. Inflammation-Immunological aspects. I. Herwald, Heiko. II. Egesten, Arne. III. Series: Contributions to microbiology; v. 17.1420-9519
[DNLM: 1. Sepsis-immunology. 2. Inflammation - immunology. W1 C0778UE V.17 2011/WC240]
RC182.S4S4565 2011
616.9' 44079 - dc22
2011012086
Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents® and Index Medicus.
Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
© Copyright 2011 by S. Karger AG, P.O. Box, CH-1009 Basel (Switzerland)
www.karger.com
Printed in Switzerland on acid-free and non-aging paper (ISO 9706) by Reinhardt Druck, Basel
ISSN 1420-9519
ISBN 978-3-8055-9710-4
e-ISBN 978-3-8055-9711-1
This book is dedicated to the memory of Roger C. Bone, 1941-1997.
 
Contents
Foreword
Herwald, H.; Egesten, A. (Lund)
Roger C. Bone, MD and the Evolving Paradigms of Sepsis
Balk, R. (Chicago, III.)
Clinical Aspects of Sepsis
Holub, M.; Závada, J. (Prague)
Virulence Factors of Gram-Negative Bacteria in Sepsis with a Focus on Neisseria meningitidis
Livorsi, D.J.; Stenehjem, E.; Stephens, D.S. (Atlanta, Ga.)
Molecular Mechanisms of Sepsis
Russell, J.A.; Boyd, J.; Nakada, T.; Thair, S.; Walley, K.R. (Vancouver, BC)
Pro-Inflammatory Mechanisms in Sepsis
Chong, D.L.W.; Sriskandan, S. (London)
Anti-Inflammatory Mechanisms of Sepsis
Shubin, N.J.; Monaghan, S.F.; Ayala, A. (Providence, R.I.)
Regulation of Pro- and Anti-Inflammatory Host Responses
van der Poll, T.; van Zoelen, M.A.D.; Wiersinga, W.J. (Amsterdam)
Future Perspectives on Regulating Pro- and Anti-Inflammatory Responses in Sepsis
Delsesto, D. (Boston, Mass.); Opal, S.M. (Pawtucket, R.I.)
Author Index
Subject Index
 
Foreword
Sepsis is a serious medical condition that is associated with high mortality despite the achievements of modern medical treatment. Keeping in mind that more than 35% of all intensive care patients suffer from septicemia at some point during their ICU stay, sepsis has to be considered a major health problem. During the course of disease, patients pass different pathophysiologic stages involving a modulation of pro- and anti-inflammatory reactions. Notably, the tightly regulated interplay of these two cascades determines an adequate immune response that is essential to erase the invading pathogen. Once this delicate balance is disturbed, a fatal outcome is often predictable. Only very recently, scientists and physicians started to appreciate the complex interaction between pro- and anti-inflammatory responses as part of the disease. This knowledge has been the template for the development of novel treatment strategies. The current volume of the book series Contributions to Microbiology is therefore an attempt to present the state of the art in this rapidly developing area of research. The book consists of eight chapters written by outstanding experts which cover the most important aspects from both a scientific and clinical point of view. It should be noted that our current knowledge has been tremendously influenced by the late Roger C. Bone. His groundbreaking work and visions are still the fundament of current concepts in severe infectious diseases and we have therefore dedicated this volume to his memory.
Heiko Herwald, Lund Arne Egesten, Lund
 
Herwald H, Egesten A (eds): Sepsis – Pro-Inflammatory and Anti-Inflammatory Responses. Contrib Microbiol. Basel, Karger, 2011, vol 17, pp 1-11
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Roger C. Bone, MD and the Evolving Paradigms of Sepsis
Robert Balk
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Rush Medical College and Rush University Medical Center, Chicago, III., USA
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Abstract
Severe sepsis and septic shock are frequent causes of ICU admission, commonly encountered complications during the course of hospitalization, and among the most common causes of death in the noncoronary ICU. Dr. Roger C. Bone was a pioneer in our struggles to improve the early recognition and management of severe sepsis and septic shock. Through his leadership and guidance, great strides were made to develop a uniform definition and to ensure the comparability of clinical research trials to evaluate new therapeutic strategies and antimediator agents. Dr. Bone also helped shape our understanding of the various stages or physiologic alterations that occur in the septic patient which also drove forward the development of new therapeutic strategies. This chapter briefly reviews the impact Roger Bone has had on our current understanding and approach to the septic patient.
Copyright © 2011 S. Karger AG, Basel
Sepsis has been described as the systemic response to an infection and has been around for centuries [ 1 - 3 ]. Early healers and clinicians had little to offer early sepsis patients before modern techniques of source control, infection control, and the era of antibiotic therapy. Unfortunately, despite an improved understanding of the pathophysiology of sepsis and modern advances in recognition along with treatment modalities, sepsis and its adverse sequelae such as shock and multiple organ dysfunction are among the most common causes of death in the noncoronary intensive care unit [ 1 - 3 ]. Sepsis is now considered the 10th leading cause of death in the United States with a progressive increase in incidence over the past several decades [ 4 - 8 ]. An estimate based on 2000 discharge coding data with extrapolation to the entire United States speculated that there would be close to a million cases of severe sepsis each year by 2010 [ 4 ]. Unfortunately, the yearly incidence of sepsis and septic shock continues to increase, related to a variety of factors, including an increased awareness of the diagnosis, an increased number of elderly and/or immunocompromized patients who have an increased susceptibility for the development of infection [ 1 ]. Increased use of aggressive chemotherapeutic and immunosuppressive therapies as well as invasive procedures that compromise normal host-defense mechanisms and normal defensive barriers also contribute to these expanding numbers [ 1 ]. Finally, there is an increasing number of microorganisms that have developed resistance to commonly employed antimicrobial regimens [ 1 ].

Fig. 1. Roger C. Bone, MD. From Chest.
While no single individual can be termed the ‘inventor or father of sepsis’, it would be difficult to identify an individual who provided more enthusiasm and guidance to understanding the pathophysiologic mechanisms and identifying optimum treatment strategies than Roger C. Bone, MD ( fig. 1 ). From the 1970s through the 1990s, Roger Bone spearheaded an attempt to bring organizatio