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Table 1 Relation of physiological events with clinical presentation and molecular biology in some acute illnesses

From: Critical care medicine in the 21st century: from CPR to PCR

Disease/syndrome

Physiological event

Clinical presentation

Molecular process

Potential new therapy

Bacterial pneumonia

Alveolar exudate

Pulmonary dysfunction

Change in cell surface

Inhaled anti-inflammatory

   

receptor affinity for

cytokines

 

Inflammatory infiltrates

 

microorganisms

 
    

Antibiotic therapy based on

 

Cell damage

 

Immune suppression

bacterial DNA susceptibility

Shock

Tissue ischemia

Organ hypoperfusion

Upregulation of ROS

Endothelial growth factors

 

Endothelial damage

 

Reduced NOS synthesis

ROS scavengers

Ventilator-induced

Alveolar disruption

Respiratory failure

Decreased synthesis and

Lung protective ventilatory

lung injury

  

denaturation of surfactant

strategies

 

Alveolar/interstitial edema

   
   

Upregulation of inflammatory

Inhaled anti-inflammatory

 

Capillary stress

 

cytokines

cytokines

SIRS

Immune suppression

Multiple organ dysfunction

Upregulation of acute phase

IL-10 gene expression vector

   

proteins and cytokines

 
 

Sustained low grade

  

Blocking EBP cellular

 

inflammation

  

receptors

  1. EBP, Endotoxin binding proteins; IL-10, interleukin-10; NOS, nitric oxide synthase; ROS, reactive oxygen species; SIRS, systemic inflammatory response syndrome.