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COMMENTS AND OPINIONS
Mortality in Humans With Pneumonia and Sepsis Is Related to an Uncompensated Anti-inflammatory Response to Infection—Reply
John A. Kellum, MD;
Derek C. Angus, MD, MPH
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In reply
We appreciate the comments of White and colleagues re garding our study characterizing the inflammatory cytokine response in pneumonia and sepsis.1 We certainly agree that classifying any cytokine as proinflammatory or anti-inflammatory is fraught with a degree of ambiguity. For example, although TNF is a prototypical proinflammatory cytokine, it has well known anti-inflammatory effects, such as inducing apoptosis.2 Likewise, IL-6 has some properties that could be classified as anti-inflammatory. However, it would be an oversimplification to consider it to be an anti-inflammatory cytokine.3 Recent studies have shown that IL-6 is essential for the development of gut barrier dysfunction after hemorrhagic shock and resuscitation in mice,4 and IL-6 may serve as the link between inflammation and thrombosis in sepsis. Isolated human umbilical vein cells treated with IL-6/IL-6 receptor complex produce thrombogenic ultralarge von Willebrand factor fragments and IL-6 also inhibits . . . [Full Text of this Article]
AUTHOR INFORMATION
RELATED ARTICLE
Understanding the Inflammatory Cytokine Response in Pneumonia and Sepsis: Results of the Genetic and Inflammatory Markers of Sepsis (GenIMS) Study
John A. Kellum, Lan Kong, Mitchell P. Fink, Lisa A. Weissfeld, Donald M. Yealy, Michael R. Pinsky, Jonathan Fine, Alexander Krichevsky, Russell L. Delude, Derek C. Angus, and for the GenIMS Investigators
Arch Intern Med. 2007;167(15):1655-1663.
ABSTRACT
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RELATED LETTER
Mortality in Humans With Pneumonia and Sepsis Is Related to an Uncompensated Anti-inflammatory Response to Infection
Mary White, Arun Mankan, Matthew W. Lawless, Michael J. O’Dwyer, Ross McManus, and Thomas Ryan
Arch Intern Med. 2008;168(13):1468-1469.
EXTRACT
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