[[ International SymposiumF02 ]]
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Stephen F Lowry, M.D. Chairman of Surgery, New York Hospital, Cornell Medical Center, U.S.A |
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The progressive deterioration of immunological and critical organ function attending severe injury or infection remains a vexing challenge. A decline in organ system function coexists with a failure to prevent erosion of host lean tissue and energy stores. Recent advances in our understanding of the potential mechanisms for these events have generated enthusiasm for active intervention against one or more purported mediator systems. While it can reasonably be assumed that both the neuro-humoral as well as cytokine mediator systems contribute significantly toward the metabolic and immunological alterations of complicated injury, the extent of their participation, either singly or in combination, at any given phase of injury remains to be fully determined. As discussed previously, a degree of both positive and negative signal modification may be operative throughout the injury and recovery process. Hence, a perspective of the balance between hormonal and cytokine influences and their potential for beneficial or adverse consequences is mandatory before appropriate interventional efforts are undertaken.
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