LEUKOCYTE RESPONSES TO INJURY

Injury elicits a response from all cells of the immune system in which cytokines and other metabolic products of activated leukocytes can ac t either beneficially to provide for enhanced host resistance or delet eriously to depress the function of remote organs and cause what has b een termed systemic inflammation. These at times antithecal responses of leukocytes that appear to integrate postinjury changes in the neuro endocrine, immune, and coagulation systems have been implicated as pri ncipal causative factors in multiple systems organ failure. Numerous i nvestigators have evaluated a variety of therapeutic agents to prevent and control infection by restoring leukocyte function, while others h ave evaluated antagonists and monoclonal antibodies as a means of cont rolling the exaggerated and persistent actions of leukocytes and cytok ines caused by systemic inflammation. The redundancies of the cell pop ulations and the cytokines and other metabolites produced by the cells predictably limit the effectiveness of any single agent and make clin ical evaluation of such agents difficult.