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Journal ArticleDOI

The immunopathogenesis of sepsis.

Jonathan Cohen
- 19 Dec 2002 - 
- Vol. 420, Iss: 6917, pp 885-891
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TLDR
Because of the high mortality of sepsis in the face of standard treatment, many efforts have been made to improve understanding of the dysregulation of the host response in sepsi, and much has been learnt of the basic principles governing bacterial–host interactions.
Abstract
Sepsis is a condition that results from a harmful or damaging host response to infection. Many of the components of the innate immune response that are normally concerned with host defences against infection can, under some circumstances, cause cell and tissue damage and hence multiple organ failure, the clinical hallmark of sepsis. Because of the high mortality of sepsis in the face of standard treatment, many efforts have been made to improve understanding of the dysregulation of the host response in sepsis. As a result, much has been learnt of the basic principles governing bacterial-host interactions, and new opportunities for therapeutic intervention have been revealed.

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Citations
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Heat Shock Protein A12B Protects Vascular Endothelial Cells Against Sepsis-Induced Acute Lung Injury in Mice

TL;DR: The administration of HSPA12B siRNA aggravated lung pathological injury, upregulated pro-inflammatory cytokine expression, and increased myeloperoxidase activity, neutrophil infiltration, pulmonary edema, and pulmonary endothelial cell apoptosis protected against sepsis-induced ALI.
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Signaling Mechanisms Regulating Endothelial Permeability

TL;DR: This review summarizes and analyzes the recent data from genetic, physiological, cellular, and morphological studies that have addressed the signaling mechanisms involved in the regulation of both the paracellular and transcellular transport pathways.
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Into the Eye of the Cytokine Storm

TL;DR: How high-throughput genomic methods are revealing the importance of the kinetics of cytokine gene expression and the remarkable degree of redundancy and overlap in cytokine signaling is highlighted.
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Role of inflammatory mediators in the pathophysiology of acute respiratory distress syndrome

TL;DR: It is reasonable to speculate that elucidation of the key mediators in ARDS coupled with the discovery of specific inhibitors would make it possible to develop clinically effective anti‐inflammatory therapy.
References
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Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock

TL;DR: This study randomly assigned patients who arrived at an urban emergency department with severe sepsis or septic shock to receive either six hours of early goal-directed therapy or standard therapy (as a control) before admission to the intensive care unit.
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Intensive Insulin Therapy in Critically Ill Patients

TL;DR: Intensive insulin therapy to maintain blood glucose at or below 110 mg per deciliter reduces morbidity and mortality among critically ill patients in the surgical intensive care unit.
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Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care.

TL;DR: Severe sepsis is a common, expensive, and frequently fatal condition, with as many deaths annually as those from acute myocardial infarction, and is especially common in the elderly and is likely to increase substantially as the U.S. population ages.
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Defective LPS Signaling in C3H/HeJ and C57BL/10ScCr Mice: Mutations in Tlr4 Gene

TL;DR: The mammalian Tlr4 protein has been adapted primarily to subserve the recognition of LPS and presumably transduces the LPS signal across the plasma membrane.
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