Inflammatory Mediators and Vascular Events

Cytokines and inflammation: modified "Miles-Wilhelm" criteria for assessing the likely roles of these substances in vivo

Cytokines (including lymphokines, interleukins, tumour necrosis factors, interferons and hemopoietic colony-stimulating factors) are a loose group of endogenous proteins which are presently being investigated for an increasingly wide range of bioactivities. Recently, cytokines have been suggested to mediate various aspects of inflammation, but the data on which these suggestions are based are often fragmentary and derive from limited experimental in vitro and in-vivo models of inflammation. Therefore, the roles of cytokines in the mediation of naturally occurring inflammatory lesions in man and animals remain unclear. This article traces the development of notions of endogenous mediators of inflammation over the last hundred years and reviews previously published ways of assessing the relevance of experimental data concerning mediators of inflammation to naturally occurring inflammatory lesions. Emphasis is given to the "criteria" advanced for this purpose by Miles and Wilhelm in the 1950s and 1960s, and additional criteria appropriate to the assessment of data concerning cytokines as mediators of inflammation are discussed.