Importance of cytokine metabolism for malnutrition, catabolism and endocrinological state in sepsis

TL;DRAbstract

One of the most pronounced metabolic alterations found in the systemic immune response syndrome (SIRS) is the induction of catabolic reactions responsible for the loss of skeletal and fat tissue [1]. A prolonged catabolic state as found in patients with severe sepsis or severe burn injury may even cause death. This process was named autocannibalism of the human body [2], a reaction which cannot be stopped by nutrition and causes death due to nitrogen depletion. This lethal nitrogen depletion includes a deteriorating function of important body proteins, but also a diminished lung or heart function because of a reduced potency to maintain adequate organ functions. Experiments performed with the infusion of multiple “catabolic” hormones such as glucagon, glucocorticoids, and catecholamines revealed that these hormones are only partly responsible for the stimulated protein degradation as found in the catabolic state [3]. Therefore, the discovery that a so-called cytokine, namely cachectin

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