S. Sipka et al., TUMOR-NECROSIS-FACTOR-ALPHA AND ADENOSINE IN ENDOTOXIN SHOCK-RELATED CARDIOVASCULAR SYMPTOMS, Mediators of inflammation, 4(6), 1995, pp. 454-455
WE have observed uncontrollable cardiogenic shock as a cardiovascular
manifestation of systemic inflammatory response syndrome (SIRS) leadin
g to death in a 62-year-old woman. The diagnosis of SIRS was based on
the demonstration of endotoxinaemia, and highly elevated plasma levels
of tumour necrosis factor (TNF)-alpha, and interleukin (IL)-10. We su
ggest that these cytokines may contribute to the terminal SIRS-related
arrythmias, impaired myocardial contractility, as well as increased v
ascular permeability. In addition the increased production of adenosin
e, a counter-regulatory mediator of inflammation may also play a role
in cardiodepression. We suggest a relationship between the action of T
NF-alpha, IL-10 and adenosine in the pathogenesis of circulatory sympt
oms described above.