In den letzten Jahren sind erhebliche Fortschritte im Verständnis der pathophysiologischen Zusammenhänge der Sepsis erzielt worden. Auch wenn diese noch nicht alle eindeutig geklärt sind, kann festgestellt werden, daβ der Tumor-Nekrose-Faktor (TNF) und das Interleukin-1 (II-1) das pathophysiologische Geschehen im septischen Schock dominieren. Beide wirken sie zytotoxisch, katabol, pyrogen und kreislaufdepressivwobei sich diese Effekte in Kombination synergistisch potenzieren. Therapeutisch sollte so früh als möglich, d.h. bei begründetem Verdacht einer Sepsis, eingegriffen werden, da diese Krankheit nach alien klinischen Erfahrungen von einem zeitlich schwer definierbaren sogenannten «point of no return» an schicksalshaft letal endet. Dabei ware die Kombination einer endotoxinneutralisierenden Substanz mit Pentoxifyllin und Il-l-RA als Zytokinmodulatoren sinnvoll.

Keywords:
Sepsis, Immunmodulation, Tumor-Nekrose-Faktor, Interleukin-1
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© 1994 S. Karger AG, Basel
1994
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