PMID: 8300243Sep 1, 1993Paper

The systemic inflammatory response syndrome (SIRS): immunology and potential immunotherapy

T DarvilleR F Jacobs


Despite widespread advances in intensive care practices, and more potent and effective antimicrobials, septic shock continues to have a mortality rate of greater than 40%. Although antimicrobials can treat the etiologic organism, they do not alter the host response. It is becoming clear that invading organisms and other insults induce the release of cytokines and secondary mediators by the host. These mediators produce alterations in cellular, metabolic and physiologic functions producing the clinical picture of septic shock. Recent advances in cellular and molecular biology have permitted the identification of some of the mediators involved in this inflammatory cascade. Potential therapies are being developed which block or interrupt their activity. Treatment populations must be meticulously defined if we are to extract useful information concerning the efficacy of these new treatment modalities. In the following, proposed definitions for clinical patterns seen in patients with sepsis, and their inherent problems when applied to pediatrics are discussed. The pathophysiology of sepsis is discussed, and specific therapies designed to interrupt the inflammatory cascade are examined.


Feb 15, 1992·Lancet·J BowenK Hansen
Feb 14, 1992·Biochemical and Biophysical Research Communications·L Agulló, A García
Sep 1, 1992·The Journal of Clinical Investigation·B P GiroirB Beutler
Apr 23, 1992·The New England Journal of Medicine·H S WarrenR S Munford
Jun 1, 1992·Proceedings of the National Academy of Sciences of the United States of America·B P GiroirB Beutler
Jan 1, 1991·Developmental and Comparative Immunology·C A Varley, J D Horton
Mar 1, 1991·Arteriosclerosis and Thrombosis : a Journal of Vascular Biology·P M BathJ F Martin
Sep 30, 1991·The American Journal of Medicine·G R Bernard
Mar 1, 1990·The Pediatric Infectious Disease Journal·R F JacobsD H Fiser
Sep 21, 1990·Science·R R SchumannR J Ulevitch
Mar 1, 1986·Proceedings of the National Academy of Sciences of the United States of America·D CaputA C Cerami
Sep 1, 1986·The Journal of Experimental Medicine·P S TobiasR J Ulevitch
Sep 30, 1988·Biochemical and Biophysical Research Communications·R M StrieterS L Kunkel
Dec 1, 1987·Proceedings of the National Academy of Sciences of the United States of America·L J IgnarroG Chaudhuri
Jan 17, 1985·The New England Journal of Medicine·J M McCord
Jan 1, 1985·Annual Review of Pharmacology and Toxicology·L J Ignarro, P J Kadowitz
Jun 1, 1987·Proceedings of the National Academy of Sciences of the United States of America·I C KettelhutA L Goldberg
Aug 18, 1988·The New England Journal of Medicine·E GirardinP H Lambert
Jan 1, 1988·Intensive Care Medicine·J P SculierJ Klastersky
May 1, 1988·The Journal of Clinical Investigation·X M Sun, W Hsueh
Mar 1, 1988·International Journal of Epidemiology·R P Wenzel
Oct 24, 1986·Science·K J TraceyJ D Albert
Jun 1, 1985·Critical Care Medicine·P V HalushkaW C Wise
Oct 1, 1985·Archives of Surgery·R J GorisJ S Gimbrère
Jun 30, 1966·Annals of the New York Academy of Sciences·W J TateW W Wells
Sep 1, 1983·Annals of Internal Medicine·R C BellW G Johanson
Nov 11, 1982·The New England Journal of Medicine·E J ZieglerA I Braude
Feb 1, 1980·Proceedings of the National Academy of Sciences of the United States of America·W F PetroneJ M McCord
Feb 1, 1980·Archives of Surgery·D E FryH C Polk
Aug 1, 1982·The Journal of Pediatrics·R M Perkin, D L Levin


Mar 1, 1995·FEMS Immunology and Medical Microbiology·E AllanG R Barclay
Dec 12, 1997·International Journal for Parasitology·I A ClarkL S Jacobson
Nov 22, 2000·The Journal of Clinical Investigation·R F GuoP A Ward
Jun 24, 2004·Best Practice & Research. Clinical Anaesthesiology·Edward R Sherwood, Tracy Toliver-Kinsky
Jun 1, 1996·Clinics in Chest Medicine·C N SesslerA A Fowler
Jul 3, 1998·European Journal of Anaesthesiology·M KristianssonM Blombäck
Mar 13, 2014·International Immunopharmacology·Shen-An HwangJeffrey K Actor
Feb 7, 2002·The Journal of Surgical Research·Rebeca M RicoLuisa A DiPietro
Jun 6, 2012·Molecules : a Journal of Synthetic Chemistry and Natural Product Chemistry·Hagit ElhawiGerardo Byk
Apr 6, 2018·Shock·Hiroshi MatsuuraTakeshi Shimazu
Feb 7, 2014·Fukushima Journal of Medical Science·Keietsu SaitoHiromasa Ohira
Aug 5, 2003·FASEB Journal : Official Publication of the Federation of American Societies for Experimental Biology·Ren-Feng GuoPeter A Ward
Jul 8, 1998·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·W HauptW Hohenberger
Mar 27, 2019·Therapeutic Delivery·Maryam A Shetab Boushehri, Alf Lamprecht

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