Immunologie in de medische praktijk. VIII. De rol van cytokinen in de pathogenese van bacteriële infectieziekten

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