IMPLICATIONS IN SEPSIS – PHYSIOPATHOLOGICAL CONSIDERATIONS IN CURRENT THERAPEUTIC CONCEPTS

Camelia Ana Grigore, Corina Cecilia Manole Palivan, Gabi Topor, Alina Calin,  Anamaria Zaharescu, Ovidiu Schipor, Kamel Earar

Abstract

In recent years, new concepts related to the physiopathology of sepsis appeared. One of the new concepts that changed the viewpoint in sepsis is the understanding of the impact of inflammation, coagulation and fibrinolysis that symultameously acts in the disease process.

Inflammation is the most common way of response of the tissues facing an aggretion (infection) even if against the resulting degradation products in the body. Inflamation  manifests by the change of local settings (celular, circulator, metabolic) and general (temperature, leukocytosis) by specific and nonspecific guarding phenomenon in interdependence. The intensity of the local and general phenomena  depends on the quality and intensity of the pathogen agent and on the reactivity of the body. In the inflammatory process, the body succeeded, normally, to block and liquidate aggression at its entrance gate. The complement system induces the release of IL-1 and TNF- α . C5a is probably the most important single fraction is the complement in the pathogenesis of sepsis because it stimulates adherence  and degranulation of neutrophils. Infancy single activation of the complement consists of opsonization of microorganisms and its products. The immune activation of the host can be made in the absence of the recognition of microbial after the signal DANGER produced by tissue ischemia and necrosis. Proinflammatory mediators in excess determines tissue damages.

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