Cohen J, Exley A R
Department of Infectious Diseases & Bacteriology, Hammersmith Hospital, Royal Postgraduate Medical School, London, England.
Schweiz Med Wochenschr. 1993 Mar 20;123(11):492-6.
The high mortality associated with septic shock has prompted intensive study of the pathophysiological basis of this syndrome in an effort to better understand the processes that lead to tissue injury. One important outcome of this work has been the recognition that the cytokine tumour necrosis factor (TNF) is an important mediator of endotoxin-induced lethality. Accordingly, studies were done which showed that antibodies to TNF could protect animals from death in a variety of model systems, and based on these findings, clinical studies were initiated. This paper reviews the present status of clinical trials of anti-TNF in sepsis. These antibodies appear to be safe, and preliminary experience suggests that they may be effective in some patients with the sepsis syndrome. A final assessment of efficacy must await the large, placebo-controlled trials that are now in progress.
与感染性休克相关的高死亡率促使人们对该综合征的病理生理基础进行深入研究，以便更好地理解导致组织损伤的过程。这项工作的一个重要成果是认识到细胞因子肿瘤坏死因子（TNF）是内毒素诱导致死的重要介质。因此，开展了多项研究，结果表明抗TNF抗体可在多种模型系统中保护动物免于死亡，基于这些发现，启动了临床研究。本文综述了抗TNF治疗脓毒症临床试验的现状。这些抗体似乎是安全的，初步经验表明它们可能对某些脓毒症综合征患者有效。疗效的最终评估必须等待目前正在进行的大型安慰剂对照试验的结果。
