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Humans↗
Biomedical subjects
B A Foëx
Publications and source records attributed to B A Foëx.
Differences in eicosanoid and cytokine production between injury/hemorrhage and bacteremic shock in the pig.
Plasma concentrations of the eicosanoids leukotriene (LT)B4, LTC4D4E4, thromboxane (TX)A2 and prostaglandin (PG)I2, and tumor necrosis factor (TNF) were measured during acute bacteremic shock and injury/hemorrhage in two porcine models. As TXA2 and PGI2 are rapidly metabolized, we measured their stable metabolites TXB2 and 6-keto-PGF1 alpha. Bacteremic shock was induced by a graded infusion of Aeromonas hydrophila over 4 h. Injury/hemorrhage was produced by a 30 min, 30% total blood volume hemorrhage followed by a 30 min shock period and then reinfusion of shed blood. Nociceptive afferent nerve stimulation was applied to the brachial plexi to mimic the cardiovascular responses to tissue injury. There was no increase in eicosanoid or TNF levels in the injury/hemorrhage model. In sepsis there was an early peak in TNF (at 60 min) followed by peaks in LTB4 and LTC4D4E4 at 180 min. Both TXB2 and 6-keto-PGF1 alpha showed large increases at the end of the study but there was no evidence that they had reached a peak. These results suggest that the very early inflammatory response in bacteremic shock and injury/hemorrhagic shock may be quite different. This may have implications for any therapies aimed at reducing the incidence of multiple organ failure after either of these physiological insults.
Animals↗
The cytokine response to critical illness.
The aims of this review are to provide a basic introduction to the biology of cytokines and to summarise the results of studies, both laboratory and clinical, relating to the cytokine response to critical illness. Elucidation of the cytokine response to conditions such as sepsis, trauma, and burns may be important for several reasons. It may improve understanding of the pathophysiological processes triggered by these insults. It may allow the severity of the insult to be gauged, and maybe even provide prognostic information about individual patients. Similarly it may allow the effectiveness of resuscitation and further treatment to be monitored. Finally, knowing about the cytokine response may provide the key to developing new treatments.
Animals↗
Early cytokine response to multiple injury.
Serial measurements of the inflammatory cytokines interleukin 6 (IL-6) and tumour necrosis factor alpha (TNF alpha) were made in four patients with multiple injuries to characterize secretion patterns and to relate them to severity of injury and degree of haemorrhage. IL-6 and TNF alpha were assayed using a sandwich ELISA. Injury scores varied from 9 to 50, and transfusion requirements varied from 7 to 14 units. All patients showed an increase in IL-6 but only one a rise in TNF alpha. There was no consistent pattern in the elevation of IL-6 and there was no relation between cytokine levels, severity of injury, transfusion requirement or ultimate outcome. From this preliminary study it would seem that measurement of IL-6 and TNF alpha is not of value in directing therapeutic decisions or as a predictor of outcome.
Adult↗