Infections and the Inflammatory Response in Acute Respiratory Distress Syndrome

Headley, A. Stacey; Tolley, Elizabeth A.; Meduri, G. Umberto

doi:10.1378/chest.111.5.1306

Cited by 223 publications

(193 citation statements)

References 31 publications

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“…13,17 Again, our findings indicate a decreasing trend in most key inflammatory cytokines with time and a significant decrease in plasma concentrations of IL-6, IL-8, and IL-10 after 7 to 10 days of corticosteroid treatment (Fig 1). The reduction in plasma cytokine levels corresponded closely with improvement in the clinical condition and resolution of inflammatory shadows on chest radiographs.…”

Section: Discussionsupporting

confidence: 51%

“…The reduction in cytokine levels also correlated with improvement in general clinical condition, pulmonary function, and survival. 13,17 In view of rapid deterioration in lung function in many adult patients during the acute phase of SARS-CoV infection, 3,8 it would be deemed unethical to withhold corticosteroid treatment in any patients who had persistent fever or progressive radiographic changes at the onset of the outbreak. 8 Hence, all except 1 patient in this cohort were treated with corticosteroids.…”

Section: Discussionmentioning

confidence: 99%

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Inflammatory Cytokine Profile in Children With Severe Acute Respiratory Syndrome

Ng¹,

Lam²,

Li³

et al. 2004

Pediatrics

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ABSTRACT. Objective. To study the inflammatory cytokine profile in children with severe acute respiratory syndrome (SARS) and to investigate whether monoclonal antibody to tumor necrosis factor-␣ (TNF-␣) could be considered for treatment of these patients.Methods. Plasma inflammatory cytokine concentrations (interleukin [IL]-1␤, IL-6, IL-8, IL-10, IL-12p70, and TNF-␣) were monitored longitudinally on admission, immediately before corticosteroids, and 1 to 2 days and 7 to 10 days after the drug treatment in a cohort of pediatric patients (n ‫؍‬ 8) with virologic confirmed SARS-associated coronavirus infection. None of the patients required mechanical ventilation or intensive care treatment. All children except 1 (patient 3) received corticosteroids.Results. Plasma IL-1␤ levels (excluding patient 3) were substantially elevated immediately before (range: 7-721 ng/L) and 7 to 10 days after (range: 7-664 ng/L) corticosteroid treatment. In contrast, the plasma concentrations of other key proinflammatory cytokines, including IL-6 and TNF-␣, were not overtly increased in any of the patients throughout the course of illness. In addition, plasma IL-10 concentration was significantly lower 1 to 2 days and 7 to 10 days after corticosteroid treatment, compared with the immediate pretreatment level. Similarly, plasma IL-6 and IL-8 concentrations were significantly decreased 7 to 10 days after the drug treatment.Conclusions. Pediatric SARS patients have markedly elevated circulating IL-1␤ levels, which suggests selective activation of the caspase-1-dependent pathway. Other key proinflammatory cytokines, IL-6 and TNF-␣, showed only mildly elevated levels at the initial phase of the illness. The current evidence does not support the use of TNF-␣ monoclonal antibody in this group of children. Pediatrics 2004;113:e7-e14. URL: http://www.pediatrics. org/cgi/content/full/113/1/e7; children, cytokines, SARS.

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Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Inflammatory Cytokine Profile in Children With Severe Acute Respiratory Syndrome

Ng¹,

Lam²,

Li³

et al. 2004

Pediatrics

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“…It has been well established that mechanical ventilation can cause biotrauma by releasing inflammatory cytokines in experimental and clinical settings (28 -30). Several clinical trials including the ARDS Network study demonstrated that patients with ARDS ventilated with low tidal volume had an improved survival rate associated with a decrease in circulating cytokine levels compared with those ventilated with high tidal volume (31,32). However, the low tidal volume strategy may not apply to all patients with ARDS (33), thus an effective pharmacologic intervention is required to treat these patients.…”

Section: Discussionmentioning

confidence: 99%

Protective effects of adenosine A2A receptor agonist in ventilator-induced lung injury in rats

Chen

Peñuelas

Quinn

et al. 2009

Critical Care Medicine

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Objectives-Mechanical ventilation is associated with overwhelming inflammatory responses that are associated with ventilator-induced lung injury (VILI) in patients with acute respiratory distress syndrome. The activation of adenosine A 2A receptors has been reported to attenuate inflammatory cascades. Hypothesis-The administration of A 2A receptors agonist ameliorates VILI.Methods-Rats were subjected to hemorrhagic shock and resuscitation as a first hit to induce systemic inflammation. The animals randomly received the selective A 2A receptor agonist CGS-21680 or a vehicle control in a blinded fashion at the onset of resuscitation phase. They were then randomized to receive mechanical ventilation as a second hit with a high tidal volume of 20 mL/kg and zero positive end-expiratory pressure, or a low tidal volume of 6 mL/kg with positive end-expiratory pressure of 5 cm H 2 O.Results-The administration of CGS-21680 attenuated lung injury as evidenced by a decrease in respiratory elastance, lung edema, lung injury scores, neutrophil recruitment in the lung, and production of inflammatory cytokines, compared with the vehicle treated animals.Conclusions-The selective A 2A receptor agonist may have a place as a novel therapeutic approach in reducing VILI.

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“…Although virulence markers have been identified in influenza viruses, it is not clear why avian hosts, chickens in particular, respond so differently to HPAIV or LPAIV infections. Clinical manifestations in birds, like humans, are most likely associated with dysregulation of proinflammatory cytokines and other host responses induced by AIV (Headley et al, 1997;To et al, 2001), but magnitudes and types of the responses are largely unknown.…”

Section: Introductionmentioning

confidence: 99%

Roles of the ERK MAPK in the regulation of proinflammatory and apoptotic responses in chicken macrophages infected with H9N2 avian influenza virus

Xing

Cardona

Anunciacion

et al. 2009

Journal of General Virology

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Infections and the Inflammatory Response in Acute Respiratory Distress Syndrome

Cited by 223 publications

References 31 publications

Inflammatory Cytokine Profile in Children With Severe Acute Respiratory Syndrome

Inflammatory Cytokine Profile in Children With Severe Acute Respiratory Syndrome

Protective effects of adenosine A2A receptor agonist in ventilator-induced lung injury in rats

Roles of the ERK MAPK in the regulation of proinflammatory and apoptotic responses in chicken macrophages infected with H9N2 avian influenza virus

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