The Pathogenesis of Sepsis

Abstract

• Sepsis and its sequelae (sepsis syndrome and sep-tic shock) are increasingly common and are still poten-tially lethal diagnoses. Many mediators of the patho-genesis of sepsis have recently been described. These include tumor necrosis factor a (TNFa), interleukins, platelet activating factor, leukotrienes, thromboxane A2, and activators of the complement cascade. Neutro-phil and platelet activation may also play a role. Other agents that may participate in the sepsis cascade include adhesion molecules, kinins, thrombin, myocar-dial depressant substance, p-endorphin, and heat shock proteins. Endothelium-derived relaxing factor and endothelin-1 are released from the endothelium and seem to exert a regulatory effect, counterbalancing each other.