SELECTIVE BLOCKADE OF INFLAMMATORY MEDIAT ORS AS THERAPEUTIC CONCEPT IN SEPSIS

Sepsis is caused by systemic distribution of microbial agents (in most cases bacteria and fungi) and/or microbial products. It is characteri zed by microcirculatory disturbances in several organs, followed by lo ss of organ function. These may be caused by some direct >>toxic<< eff icacy of microbial products (exotoxins, endotoxins), as well as indire ctly via activation of a variety of mediator systems and inflammatory competent cells (whole-body inflammation). This pathogenic sequence su ggests therapeutic attempts to interfere with the systemic distributio n of inflammatory mechanisms. High dose corticosteroids have shown no benefit under these conditions in controlled clinical trials. This rev iew summarises current approaches to suppress inflammatory mechanisms in sepsis by blocking a variety of inflammatory mediators or inflammat ory competent cells.