Severe acute pancreatitis between systematic inflammatory response syndrome and sepsis: insights from a mathematical model of endotoxin tolerance

نویسندگان

  • Catalin Vasilescu
  • Mircea Olteanu
  • Paul Flondor
چکیده

In order to evaluate the degree of endotoxin tolerance, expressed by the reduced cytokine/releasing capacity of the whole blood, data from a group of patients with trauma, severe acute pancreatitis (SAP), and diffuse peritonitis were analyzed. In SAP endotoxin levels and the tumor necrosing factor (TNF)– releasing capacity of the whole blood under lipopolysaccharide (LPS) stimulation were of an intermediate degree between systemic inflammatory response syndrome and severe sepsis. A mathematical model of ordinary differential equations of LPS signaling based on endotoxin kinetics and endotoxin tolerance was constructed. The mathematical model was used to reproduce the TNFproduction in trauma, SAP and peritonitis patients. The results of these numerical simulations are very similar to the determinations in real patients and argue that endotoxin tolerance may be a component of the immune dysregulation that complicates the clinical evolution of the patient with SAP. © 2007 Excerpta Medica Inc. All rights

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تاریخ انتشار 2007