Severe acute pancreatitis between systematic inflammatory response syndrome and sepsis: insights from a mathematical model of endotoxin tolerance
| Autor: | Catalin Vasilescu, Klaus Buttenschoen, Paul Flondor, Mircea Olteanu |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Lipopolysaccharide
business.industry Peritonitis General Medicine Immune dysregulation medicine.disease medicine.disease_cause Sepsis Systemic inflammatory response syndrome chemistry.chemical_compound chemistry Immunology medicine Pancreatitis Acute pancreatitis Surgery Tumor necrosis factor alpha business |
| Zdroj: | The American Journal of Surgery. 194:S33-S38 |
| ISSN: | 0002-9610 |
| DOI: | 10.1016/j.amjsurg.2007.05.002 |
| Popis: | In order to evaluate the degree of endotoxin tolerance, expressed by the reduced cytokine/releasing capacity of the whole blood, data from a group of patients with trauma, severe acute pancreatitis (SAP), and diffuse peritonitis were analyzed. In SAP endotoxin levels and the tumor necrosing factor (TNF-α)–releasing capacity of the whole blood under lipopolysaccharide (LPS) stimulation were of an intermediate degree between systemic inflammatory response syndrome and severe sepsis. A mathematical model of ordinary differential equations of LPS signaling based on endotoxin kinetics and endotoxin tolerance was constructed. The mathematical model was used to reproduce the TNF-α production in trauma, SAP and peritonitis patients. The results of these numerical simulations are very similar to the determinations in real patients and argue that endotoxin tolerance may be a component of the immune dysregulation that complicates the clinical evolution of the patient with SAP. |
| Databáze: | OpenAIRE |
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