caa a22 4500 477035701 CHVBK 20180405111304.0 cr unu---uuuuu 170330e19960501xx s 000 0 eng 10.1007/s002689900069 doi (NATIONALLICENCE)springer-10.1007/s002689900069 Biologic Control of Injury and Inflammation: Much More than Too Little or Too Late [Elektronische Daten] [Xavier Guirao, Stephen F. Lowry] Abstract. A generalized host inflammatory response is necessary to orchestrate the maintenance or recovery of tissue repair and immune competence following severe injury or infection. When excessive in initial magnitude or duration, however, these otherwise beneficial inflammatory processes may eventuate in deterioration rather than restoration of homeostasis. Although the adverse consequences of excessive inflammatory stimuli may be acutely evident, their influences are more often insidious. A complex cascade of endogenously derived proinflammatory mediators are currently hypothesized to be responsible for both the beneficial and the adverse sequelae of infection and injury. The cytokine proteins tumor necrosis factor and interleukin 1 have been most widely studied as potential targets for antagonist intervention in both experimental models and prospective clinical trials. Preclinical evidence supporting these approaches is briefly discussed herein, as are the results of clinical trials attempting to modulate cytokine influences in the presence of sepsis. The present discussion focuses on potential insights gained from these investigations and the evolving appreciation for the importance of cytokine counterregulatory mechanisms. Examples of potentially complex interactions between inflammatory cytokines and infection-induced antagonist proteins or counterregulatory hormones are provided. It is hypothesized that a sustained imbalance among these proinflammatory and counterregulatory influences may be a critical determinant of outcome in patients with severe infection.: 1996 by the Société Internationale de Chir, ugie Guirao Xavier Department of Surgery, Laboratory of Surgical Metabolism, New York Hospital, Cornell University Medical College, 525 East 68 Street, New York, New York 10021, U.S.A., US aut Lowry Stephen F. Department of Surgery, Laboratory of Surgical Metabolism, New York Hospital, Cornell University Medical College, 525 East 68 Street, New York, New York 10021, U.S.A., US aut https://doi.org/10.1007/s002689900069 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002689900069 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Guirao Xavier Department of Surgery, Laboratory of Surgical Metabolism, New York Hospital, Cornell University Medical College, 525 East 68 Street, New York, New York 10021, U.S.A., US aut NATIONALLICENCE 700 1- Lowry Stephen F. Department of Surgery, Laboratory of Surgical Metabolism, New York Hospital, Cornell University Medical College, 525 East 68 Street, New York, New York 10021, U.S.A., US aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer