Considering immunomodulatory therapies in the septic patient: should apoptosis be a potential therapeutic target?

被引:26
作者
Oberholzer, A [1 ]
Oberholzer, C [1 ]
Minter, RM [1 ]
Moldawer, LL [1 ]
机构
[1] Univ Florida, Shands Hosp, Coll Med, Dept Surg, Gainesville, FL 32610 USA
关键词
sepsis; apoptosis; T-cell;
D O I
10.1016/S0165-2478(00)00307-2
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Treatment of sepsis and septic shock remains a clinical conundrum. Recent prospective trials with anti-cytokine and anti-inflammatory therapies have shown only modest clinical benefit. The successful treatment of the patient with sepsis syndrome will likely require multi-modal therapies aimed at several of the immunological and physiological disturbances which are occurring simultaneously. Recent studies in experimental animals and critically ill patients have suggested that increased apoptosis of lymphoid organs and some parenchymal tissues may contribute to the immune suppression, anergy and organ system dysfunction. Therapies aimed at inhibiting lymphoid cell apoptosis may contribute to improved outcome, and should be considered in the treatment of hospitalized patients with sepsis syndromes. Although clinical trials with anti-apoptotic agents remain distant due in large part to technical difficulties associated with their administration and tissue targeting, inhibition of lymphocyte apoptosis may be an appropriate therapeutic target for the septic patient. (C) 2001 Elsevier Science B.V. All rights reserved.
引用
收藏
页码:221 / 224
页数:4
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