Sepsis and the Lung Host Response

Charles W. Frevert; Thomas R. Martin

doi:10.1055/s-2004-822308

Seminars in Respiratory and Critical Care Medicine, Table of Contents

Semin Respir Crit Care Med 2004; 25(1): 85-93
DOI: 10.1055/s-2004-822308

Published by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Sepsis and the Lung Host Response

Charles W. Frevert¹ ^, ² , Thomas R. Martin¹ ^, ²

¹Medical Research Service of the VA Puget Sound Medical Center, Seattle, Washington
²Division of Pulmonary and Critical and Care Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington

Abstract

Sepsis is the leading cause of death in critically ill patients and is the most common risk factor for the development of acute lung injury in medical patients. Initially investigators hypothesized that an excessive proinflammatory response contributed to the pathogenesis of sepsis. However, this hypothesis overlooked the beneficial effects of proinflammatory mediators and the detrimental effects of an excessive anti-inflammatory response. This has led to a new hypothesis where sepsis is characterized by imbalances of the pro- and anti-inflammatory responses, with tissue injury the result of an excessive proinflammatory response and impaired pulmonary host defense the result of an excessive anti-inflammatory response. This article reviews clinical studies and animal models which show that sepsis results in an impaired lung host response to bacteria. Information in this article should provide the reader with an increased understanding of the pathogenesis of sepsis and the realization that new therapeutic strategies for sepsis need to take into account the need to balance pro- and anti-inflammatory responses to maintain pulmonary host defenses and prevent the development of acute lung injury.

KEYWORDS

Sepsis - innate immunity - pulmonary host defenses

Full Text

References

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Charles W FrevertD.V.M. Sc.D.

VA Puget Sound Medical Center

GMR151-L, 1660 South Columbian Way

Seattle, WA

Email: cfrevert@u.washington.edu