Effects on complement activation and cytokine (TNF-alpha and IL-8) release of infusion of anti-TNF-antibodies or a xanthine derivative (HWA 138) in septic baboons

Pathophysiology of sepsis-related cardiac dysfunction: driven by inflammation, energy mismanagement, or both?

Sepsis is a systemic inflammatory response that follows bacterial infection. Cardiac dysfunction is an important consequence of sepsis that affects mortality and has been attributed to either elevated inflammation or suppression of both fatty acid and glucose oxidation and eventual ATP depletion. Moreover, cardiac adrenergic signaling is compromised in septic patients and this aggravates further heart function. While anti-inflammatory therapies are important for the treatment of the disease, administration of anti-inflammatory drugs did not improve survival in septic patients. This review article summarizes findings on inflammatory and other mechanisms that are triggered in sepsis and affect cardiac function and mortality. Particularly, it focuses on the effects of the disease in metabolic pathways, as well as in adrenergic signaling and the potential interplay of the latter with inflammation. It is suggested that therapeutic approaches should include combination of anti-inflammatory treatments, stimulation of energy production, and restoration of adrenergic signaling in the heart.

Determination of C5a in murine models of staphylococcal enterotoxin B-induced toxic shock

Robust host innate immune response to staphylococcal enterotoxin B (SEB) and structurally related superantigens causes toxic shock and various autoimmune diseases. While proinflammatory cytokines are known for mediating SEB-induced toxicity, the role of complement C5a in SEB-mediated shock is less well-understood. An ELISA was developed to measure the complement activation product, C5a, in different murine models of toxic shock. This assay provides easy, quantifiable data for complement activation and its role in various SEB-induced toxic shock models.

State-of-the-art blood saving techniques

Preoperative autologous donation, the use of erythropoietin, acute normovolaemic haemodilution, acceptance of minimal perioperative haemoglobin levels, the use of specific drugs (aprotinin, antifibrinolytics), cell saving and a meticulous surgical technique aimed at minimizing blood loss have all been described as blood saving techniques. Each has proved effective in reducing the need for allogeneic blood transfusions. With an appropriate selection of patients, all techniques can be used efficiently.

Pentoxifylline influences the autocrine function of organ cultured donor corneas and enhances endothelial cell survival

BACKGROUND/AIMS

Scientific interest in pentoxifylline has been reawakened owing to the recognised effects of this drug on immune functions, particularly its influence on cytokine production. In a previous study, the authors demonstrated that spiking of organ culture media with endotoxin elicited a marked enhancement in the release of IL-6 and IL-8 from corneal tissue and that these events coincided with degenerative changes in endothelial cells and a higher incidence of actual loss among this population. Since traces of donor derived endotoxin can be detected in up to 50% of corneal organ cultures, this substance may have a direct influence on graft viability or trigger inflammatory responses in the host. They, therefore, wished to ascertain whether supplementation of media with pentoxifylline improved endothelial cell survival in organ cultured donor corneas.

METHODS

12 fellow pairs of donor corneas were cultured for 20 days, with a change of medium on day 10: One of each pair was incubated in the absence, and the other in the presence, of pentoxifylline (25 microg/ml). Samples of medium were withdrawn at regular intervals during the course of incubation and screened for cytokines IL-6, IL-8, and prostaglandin E2 by ELISA. Endothelial cell morphology and numerical density were assessed on days 0, 10 and 20.

RESULTS

Addition of pentoxifylline to organ culture media led to a significant improvement in endothelial cell survival. This drug also elicited a significant increase in the level of IL-6 and marginally suppressed that of IL-8 during the initial 10 day phase of incubation. During the second 10-20 day phase, the level of both IL-6 and IL-8 decreased significantly in the presence of pentoxifylline, the relation between these two cytokines being the inverse of that observed in the absence of the drug. No significant changes in the level of prostaglandin E2 were apparent.

CONCLUSION

The addition of pentoxifylline to organ culture media leads, ultimately, to a suppression of IL-6 and IL-8 secretion by corneal tissue. The potentially damaging effects of these cytokines are thereby quelled, as evidenced by the improvement in endothelial cell survival.