Respuesta inflamatoria sistémica: definiciones, marcadores inflamatorios y posibilidades terapéuticas

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"apellidos" => "García de Lorenzo" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "1" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "apellidos" => "Mateos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "J." "apellidos" => "López Martínez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "**" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "M." "apellidos" => "Sánchez Castilla" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "***" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Intensiva. Hospital Universitario La Paz" "etiqueta" => "*" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Cuidados Intensivos" "etiqueta" => "**" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Anestesia y Reanimación. Hospital Severo Ochoa. Leganés. Madrid" "etiqueta" => "***" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Correspondencia: Dr. A. García de Lorenzo y Mateos. Servicio de Medicina Intensiva. Hospital Universitario La Paz. Paseo de la Castellana, 261. 28046 Madrid" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Systemic inflammatory response: definitions, inflammatory markers and therapeutic possibilities" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaAceptado" => "2000-06-05" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec82368" "palabras" => array:5 [ 0 => "SIRS" 1 => "CARS" 2 => "síndrome de disfunción multisistémica" 3 => "marcadores inflamatorios" 4 => "reactantes de fase aguda" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec82367" "palabras" => array:5 [ 0 => "SIRS" 1 => "CARS" 2 => "multysystemic dysfunction syndrome" 3 => "inflammatory markers" 4 => "acute phase reactants" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "IntroducciónSe analizan las definiciones y las teorías fisiopatológicas que se han elaborado para explicar la evolución del síndrome inflamatorio hacia la disfunción multisistémica, analizando el valor predictivo de los diferentes mediadores y de los cambios metabólicos. Tras revisar las características del síndrome inflamatorio se recogen los diferentes intentos terapéuticos para modular el SIRS MaterialSe ha revisado la bibliografía recogida en Medline, fundamentalmente estudios clínicos realizados en pacientes críticos ResumenSe describen tres síndromes (SIRS, CARS y MARS) que pueden configurar la respuesta inflamatoria. La evolución hacia la disfunción multisistémica es explicada por diversas teorías, pero queda por estudiar los mecanismos que permiten la modulación y supresión de la respuesta inflamatoria. A pesar de su importancia fisiopatológica, las citocinas de inicio no son buenos marcadores pronósticos. Los marcadores de fase aguda, así como los cambios en el metabolismo lipídico y del hierro, muestran una mejor correlación con la evolución. Tras comentar que la respuesta inflamatoria no es proporcional, estructural ni universal, se revisan los diversos intentos terapéuticos que pretenden antagonizar dicha respuesta. Se comentan las tres líneas que deben regir para las investigaciones futuras" ] "en" => array:1 [ "resumen" => "IntroductionThe different syndrome definitions that have been developed to explain how the inflammatory syndrome may herald multisystemic dysfunction. Thus, the predictive value of the different mediators and metabolic changes have been analyzed. Once the inflammatory syndrome features were revised, those therapeutic approaches that will likely improve its prognosis are resumed MethodsSystematic review of Medline’s bibliography, focusing on clinical trials performed in critically ill patients SummaryThree syndromes (SIRS, CARS, MARS) which can comprise the inflammatory syndome are described. Several hypothesis illustrate its progression to multisystemic dysfunction, but further research is required to explain how inflammation can be regulated or even suppressed. Early relieved cytokines play a major role, but are devoid of prognostic value; on the other hand acute phase markers and changes in lipid and iron metabolism correlate better with final outcome. While the inflammatory reaction is by no means proportional, structural nor universal we turn to assay the different therapeutic approaches intended to antagonize it. The three principles which should underlie further research are reviewed" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:87 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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Systemic inflammatory response: definitions, inflammatory markers and therapeutic possibilities

A. García de Lorenzo*,1, Mateos*, J. López Martínez**, M. Sánchez Castilla***

* Servicio de Medicina Intensiva. Hospital Universitario La Paz

** Unidad de Cuidados Intensivos

*** Servicio de Anestesia y Reanimación. Hospital Severo Ochoa. Leganés. Madrid

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      "en" => array:1 [
        "titulo" => "Systemic inflammatory response&#58; definitions&#44; inflammatory markers and therapeutic possibilities"
      ]
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    "fechaAceptado" => "2000-06-05"
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            0 => "SIRS"
            1 => "CARS"
            2 => "s&#237;ndrome de disfunci&#243;n multisist&#233;mica"
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            4 => "reactantes de fase aguda"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Se analizan las definiciones y las teor&#237;as fisiopatol&#243;gicas que se han elaborado para explicar la evoluci&#243;n del s&#237;ndrome inflamatorio hacia la disfunci&#243;n multisist&#233;mica&#44; analizando el valor predictivo de los diferentes mediadores y de los cambios metab&#243;licos&#46; Tras revisar las caracter&#237;sticas del s&#237;ndrome inflamatorio se recogen los diferentes intentos terap&#233;uticos para modular el SIRS</p> <span class="elsevierStyleSectionTitle">Material</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se ha revisado la bibliograf&#237;a recogida en Medline&#44; fundamentalmente estudios cl&#237;nicos realizados en pacientes cr&#237;ticos</p> <span class="elsevierStyleSectionTitle">Resumen</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se describen tres s&#237;ndromes &#40;SIRS&#44; CARS y MARS&#41; que pueden configurar la respuesta inflamatoria&#46; La evoluci&#243;n hacia la disfunci&#243;n multisist&#233;mica es explicada por diversas teor&#237;as&#44; pero queda por estudiar los mecanismos que permiten la modulaci&#243;n y supresi&#243;n de la respuesta inflamatoria&#46; A pesar de su importancia fisiopatol&#243;gica&#44; las citocinas de inicio no son buenos marcadores pron&#243;sticos&#46; Los marcadores de fase aguda&#44; as&#237; como los cambios en el metabolismo lip&#237;dico y del hierro&#44; muestran una mejor correlaci&#243;n con la evoluci&#243;n&#46; Tras comentar que la respuesta inflamatoria no es proporcional&#44; estructural ni universal&#44; se revisan los diversos intentos terap&#233;uticos que pretenden antagonizar dicha respuesta&#46; Se comentan las tres l&#237;neas que deben regir para las investigaciones futuras</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The different syndrome definitions that have been developed to explain how the inflammatory syndrome may herald multisystemic dysfunction&#46; Thus&#44; the predictive value of the different mediators and metabolic changes have been analyzed&#46; Once the inflammatory syndrome features were revised&#44; those therapeutic approaches that will likely improve its prognosis are resumed</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Systematic review of Medline&#8217;s bibliography&#44; focusing on clinical trials performed in critically ill patients</p> <span class="elsevierStyleSectionTitle">Summary</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Three syndromes &#40;SIRS&#44; CARS&#44; MARS&#41; which can comprise the inflammatory syndome are described&#46; Several hypothesis illustrate its progression to multisystemic dysfunction&#44; but further research is required to explain how inflammation can be regulated or even suppressed&#46; Early relieved cytokines play a major role&#44; but are devoid of prognostic value&#59; on the other hand acute phase markers and changes in lipid and iron metabolism correlate better with final outcome&#46; While the inflammatory reaction is by no means proportional&#44; structural nor universal we turn to assay the different therapeutic approaches intended to antagonize it&#46; The three principles which should underlie further research are reviewed</p>"
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Información del artículo

ISSN: 02105691
Idioma original: Español

DOI:10.1016/S0210-5691(00)79623-9

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