ROLE OF INTERLEUKIN-1 AND THE THERAPEUTIC POTENTIAL OF INTERLEUKIN-1 RECEPTOR ANTAGONIST IN SEPSIS

Clinical trials of anticytokines in sepsis have not been as straightfo rward as had been anticipated from results in animal models of sepsis and the role of cytokines in sepsis is now in question, Retrospective analysis of the results of a phase III trial of interleukin-1 (IL-1) r eceptor antagonist suggests that sepsis-induced adult respiratory dist ress syndrome (ARDS), disseminated intravascular coagulation (DIC), re nal dysfunction, and shock are valuable markers of patients in whom IL -1 is a pathogenic mediator and in whom IL-1 ra can reduce mortality. A re-examination of the effects of IL-1ra in animal models of sepsis s upports the validity of this analysis. A new phase III clinical trial will confirm or disprove the hypothesis that IL-1 is a mediator of pat hology, and IL-1ra is a valuable therapy for sepsis complicated by ARD S, DIG, renal dysfunction, or shock. (C) 1994 Wiley-Liss, Inc.