van der Poll T, Speelman P, van Deventer S J
Academisch Medisch Centrum, afd. Inwendige Geneeskunde, Amsterdam.
Ned Tijdschr Geneeskd. 1998 Jan 3;142(1):14-7.
Cytokines are small proteins that can be produced by many different cell types involved in inflammation. The cytokine network consists of pro-inflammatory cytokines, facilitating inflammation, and anti-inflammatory cytokines, reducing inflammation at least in part by inhibiting the production of pro-inflammatory cytokines. The production of cytokines is enhanced during bacterial infections. The balance between pro- and anti-inflammatory cytokines critically determines the outcome of infection. Excessive systemic release of pro-inflammatory cytokines such as tumour necrosis factor alpha and interleukin 1 may contribute to organ failure in patients with fulminant sepsis. On the other hand, the local action of pro-inflammatory cytokines, at the site of a compartmentalized infection, is required for an adequate host antibacterial defence. Therefore, neutralization of pro-inflammatory cytokines may benefit some patients with bacterial sepsis but harm others.
细胞因子是一类小分子蛋白质，可由许多参与炎症反应的不同细胞类型产生。细胞因子网络由促炎细胞因子和抗炎细胞因子组成，促炎细胞因子促进炎症反应，抗炎细胞因子至少部分通过抑制促炎细胞因子的产生来减轻炎症。在细菌感染期间，细胞因子的产生会增强。促炎细胞因子和抗炎细胞因子之间的平衡关键地决定了感染的结果。促炎细胞因子如肿瘤坏死因子α和白细胞介素1的过度全身性释放可能导致暴发性脓毒症患者出现器官衰竭。另一方面，在局部感染部位，促炎细胞因子的局部作用是宿主充分的抗菌防御所必需的。因此，中和促炎细胞因子可能使一些细菌性脓毒症患者受益，但对另一些患者有害。
