MEDIATORS AND ANTAGONISTS IN THE TREATMEN T OF TRAUMA - DOES IT MAKE SENSE

The response of the immune system to any trauma starts at the moment o f injury. Macrophages are activated and produce proinflammatory mediat ors. All the stimuli of the cytokine system lead to a final common pat hway where a therapeutic approach might start. However, any strategy o f cytokine therapy cuts both ways. There are a lot of data derived fro m in vitro and animal studies. Both the classification and the clinica l application of these results are rather difficult. Some therapeutic concepts seem promising, but the advantages and disadvantages have to be carefully considered. The aim of all strategies must be to improve or adjust the patient's immune defence system. First of all,the patien t, the disease or the specific injury has to be treated, not only the mediators and cytokines. The philosopher's stone has not been found ye t. There are several approaches, but it is still a long and difficult process to find new insights and effective treatments.