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HLA-DR expression, cytokines and bioactive lipids in sepsis

Sepsis accounts for more than 200,000 deaths annually in the USA alone. Both inflammatory and anti-inflammatory responses occur simultaneously in sepsis, the early phase dominated by the hyperinflammatory response and the late phase by immunosuppression. This late immunosuppression phase leads to lo...

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Autor principal: Das, Undurti
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4042054/
https://www.ncbi.nlm.nih.gov/pubmed/24904669
http://dx.doi.org/10.5114/aoms.2014.42586
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author Das, Undurti
author_facet Das, Undurti
author_sort Das, Undurti
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description Sepsis accounts for more than 200,000 deaths annually in the USA alone. Both inflammatory and anti-inflammatory responses occur simultaneously in sepsis, the early phase dominated by the hyperinflammatory response and the late phase by immunosuppression. This late immunosuppression phase leads to loss of the delayed type hypersensitivity response, failure to clear the primary infection and development of secondary infections. Based on the available data, I hypothesize that failure to produce adequate amounts of inflammation resolving lipid mediators may be at the centre of both the hyperinflammatory response and late immunosuppression seen in sepsis. These proresolving lipids – lipoxins, resolvins and protectins – suppress exacerbated activation of leukocytes and macrophages, inhibit excess production of pro-inflammatory cytokines, initiate resolution of inappropriate inflammation, augment clearance of bacteria and other pathogens, and restore homeostasis. If true, this implies that administration of naturally occurring lipoxins, resolvins, protectins, maresins and nitrolipids by themselves or their more stable synthetic analogues such as 15-epi-16-(para-fluorophenoxy)-lipoxin A(4)-methyl ester, a synthetic analogue of 15-epi-lipoxin A(4), and 15(R/S)-methyl-LXA(4) may form a new approach in the prevention (in the high-risk subjects), management of sepsis and in resolving the imbalanced inflammatory process such that sepsis is ameliorated early. In addition, recent studies have suggested that nociceptin and cold inducible RNA binding protein (CIRBP) also have a role in the pathobiology of sepsis. It is suggested that both nociceptin and CIRBP inhibit the production of lipoxins, resolvins, protectins, maresins, and nitrolipids and thus play a role in sepsis and septic shock.
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spelling pubmed-40420542014-06-05 HLA-DR expression, cytokines and bioactive lipids in sepsis Das, Undurti Arch Med Sci State of the Art Papers Sepsis accounts for more than 200,000 deaths annually in the USA alone. Both inflammatory and anti-inflammatory responses occur simultaneously in sepsis, the early phase dominated by the hyperinflammatory response and the late phase by immunosuppression. This late immunosuppression phase leads to loss of the delayed type hypersensitivity response, failure to clear the primary infection and development of secondary infections. Based on the available data, I hypothesize that failure to produce adequate amounts of inflammation resolving lipid mediators may be at the centre of both the hyperinflammatory response and late immunosuppression seen in sepsis. These proresolving lipids – lipoxins, resolvins and protectins – suppress exacerbated activation of leukocytes and macrophages, inhibit excess production of pro-inflammatory cytokines, initiate resolution of inappropriate inflammation, augment clearance of bacteria and other pathogens, and restore homeostasis. If true, this implies that administration of naturally occurring lipoxins, resolvins, protectins, maresins and nitrolipids by themselves or their more stable synthetic analogues such as 15-epi-16-(para-fluorophenoxy)-lipoxin A(4)-methyl ester, a synthetic analogue of 15-epi-lipoxin A(4), and 15(R/S)-methyl-LXA(4) may form a new approach in the prevention (in the high-risk subjects), management of sepsis and in resolving the imbalanced inflammatory process such that sepsis is ameliorated early. In addition, recent studies have suggested that nociceptin and cold inducible RNA binding protein (CIRBP) also have a role in the pathobiology of sepsis. It is suggested that both nociceptin and CIRBP inhibit the production of lipoxins, resolvins, protectins, maresins, and nitrolipids and thus play a role in sepsis and septic shock. Termedia Publishing House 2014-05-13 2014-05-12 /pmc/articles/PMC4042054/ /pubmed/24904669 http://dx.doi.org/10.5114/aoms.2014.42586 Text en Copyright © 2014 Termedia & Banach http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle State of the Art Papers
Das, Undurti
HLA-DR expression, cytokines and bioactive lipids in sepsis
title HLA-DR expression, cytokines and bioactive lipids in sepsis
title_full HLA-DR expression, cytokines and bioactive lipids in sepsis
title_fullStr HLA-DR expression, cytokines and bioactive lipids in sepsis
title_full_unstemmed HLA-DR expression, cytokines and bioactive lipids in sepsis
title_short HLA-DR expression, cytokines and bioactive lipids in sepsis
title_sort hla-dr expression, cytokines and bioactive lipids in sepsis
topic State of the Art Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4042054/
https://www.ncbi.nlm.nih.gov/pubmed/24904669
http://dx.doi.org/10.5114/aoms.2014.42586
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