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The Systemic Pro-Inflammatory Response in Sepsis

de Jong H.K.a · van der Poll T.a, b · Wiersinga W.J.a, b

Author affiliations

aCenter for Molecular Medicine and bDepartment of Internal Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands

Corresponding Author

Dr. Willem Joost Wiersinga

Department of Internal Medicine

Academic Medical Centre, University of Amsterdam

Room G2-132, Meibergdreef 9, NL–1105 AZ Amsterdam (The Netherlands)

Tel. +31 20 566 9111, Fax +31 20 697 7192, E-Mail w.j.wiersinga@amc.uva.nl

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J Innate Immun 2010;2:422–430

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The systemic inflammatory response syndrome (SIRS) is the predominantly cytokine-mediated, pro-inflammatory response of the host to invading pathogens and is considered the hallmark sign of sepsis. Molecular components of this response can be divided into cytokines, plasma cascades and acute phase proteins while the predominant cellular components are leukocytes and the endothelium. High-throughput genetic profiling studies have led to increased insights into leukocyte regulation during sepsis. New players in the pro-inflammatory cytokine network include interleukin-17, high-mobility group box-1 protein, macrophage migration inhibitory factor, the myeloid-related proteins Mrp8 and Mrp14, and soluble triggering receptor expressed on myeloid cells-1. Activation of coagulation with concurrent downregulation of anticoagulant systems and fibrinolysis are almost universally present in septic patients with SIRS. Increasing evidence points to an extensive cross-talk between inflammation and coagulation, in which the protease-activated cell receptors play an important role. Sepsis causes excessive activation of the complement system in which C5a plays a key part. Further dissection of the role of host-pathogen interactions, the cytokine network, the coagulation cascade, the complement system and their multidirectional interactions in sepsis will pave the way for new treatment targets that can modify the excessive and collective activation of all these systems.

© 2010 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Review

Received: February 22, 2010
Accepted: April 05, 2010
Published online: June 08, 2010
Issue release date: August 2010

Number of Print Pages: 9
Number of Figures: 2
Number of Tables: 0

ISSN: 1662-811X (Print)
eISSN: 1662-8128 (Online)

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