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Immunologic therapy for ARDS, septic shock, and multiple-organ failure

R C St John1, P M Dorinsky

  • 1Department of Medicine, Ohio State University, Columbus 43210.

Chest
|March 1, 1993
PubMed
Summary

Novel immunologic therapies targeting the inflammatory cascade show promise for treating septic shock, acute respiratory distress syndrome (ARDS), and multiple organ failure (MOF). Combinations of treatments may be necessary due to the complexity of these critical conditions.

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Area of Science:

  • Immunology
  • Molecular Biology
  • Critical Care Medicine

Background:

  • Supportive care improvements have not sufficiently reduced mortality in septic shock, ARDS, and MOF.
  • Advances in understanding cytokine biology and molecular pathways are crucial for developing new treatments.

Purpose of the Study:

  • To review the current status of novel immunologic therapies for septic shock, ARDS, and MOF.
  • To explore therapeutic strategies targeting different levels of the inflammatory cascade.

Main Methods:

  • Review of current literature on immunologic approaches to critical care disorders.
  • Analysis of therapies targeting endotoxin, inflammatory mediators (TNF, IL-1), and effector cells (neutrophils).

Main Results:

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  • Individual novel therapies demonstrate potential in treating these complex conditions.
  • The inflammatory cascade is complex and redundant, suggesting single agents may be insufficient.

Conclusions:

  • Combination therapies are likely required to significantly improve survival rates.
  • Molecular-level understanding of ARDS, septic shock, and MOF pathogenesis provides new therapeutic avenues.