Pancreatic enzymes and microvascular cell activation in multiorgan failure

Cell activation in the microcirculation leads to an inflammatory cascade an d is accompanied by many cardiovascular complications. There is a need to i dentify the trigger mechanisms that lead to the production of in vivo activ ating factors. We review here mechanisms for cell activation in the microci rculation and specifically the production of humoral cell activators in phy siological shock. The elevated levels of activating factors in plasma could be traced to the action of pancreatic enzymes in the ischemic intestine. N ew interventions against the production of the activators are proposed. The evidence suggests that pancreatic enzymes in the ischemic intestine may at tack several tissue components and generate cellular activators that are as sociated with multiorgan dysfunction in physiological shock.