Lipid Mediators in the Immunology of Shock

This book contains the proceedings of the ARW NATO conference on Lipid Mediators in Immunology of Burn and Sepsis held in He1singor, Denmark, July 20-25, 1986. This meeting brought together some of the most distinguished re searchers in the fields of thermal injury, the immune system and lipid mediator biochemistry. It is well known that there is a substantial impairment of the immune response during sepsis, burn, trauma and other kinds of shock. These conditions are characterized by a massive inflammatory process which occurs during the early phase following injury. Among the various mediators released at this time are 1euko trienes, thromboxane, histamine and platelet-activating factor. This latter autocoid possesses potent proinf1ammatory properties and toge ther with the other mediators may account for some of the post-injury pathophysi 01 ogi ca 1 phenomena such as extravasati on, hypotensi on, chemotaxis. . . It is of great interest to note that recently 1euko tri enes and plate 1 et-acti vati ng factor have been shown to be potent mediators of the immune response. Thus, the purpose of this meeting was to bring together clinicians, immunologists and biochemists in order to examine and hopefully clarify the putative role of various lipid mediators prominent in the early stages after injury. This book is divided into the following six sections. Section 1 provides a general overview of the physiological con sequences of burn, sepsis and shock.

Inhalt
I - Burn, Sepsis and Shock Overviews.- Burn and Sepsis: Immunological Overview.- Burns: Clinical and Biological Overview.- Infection: Cause or Effect of Pathophysiologic Change in Burn and Trauma Patients.- Biochemical Mediators in Acute Respiratory Distress Syndrome (ARDS) After Burning Injury.- Sepsis Parameters in Patients with Lethal Burn.- Computer Assisted 10 MHZ Sonography of Burn Depth in Man - A Quantitative Guide For the Surgical Strategy of Sepsis Prevention.- Pharmacological Control of Hemorrhagic Shock : Does Hypertonic Resuscitation Qualify ?.- 2 - Mediators of Burn and Sepsis.- Oxygen, Free Radicals, Shock and Trauma.- Role of Free Radical Lipid Peroxidation in Burn and Endotoxin Shock.- The Significance of Pentane Measurements in Man.- Detection of Pentane as a Measurement of Lipid Peroxidation in Humans Using Gas Chromatography With a Photoionization Detector.- Eicosanoids and The Pathophysiology of Sepsis and Trauma.- Lipid Metabolism During Starvation and Sepsis in Relation to Fatty Acid Profile in Liver and ?-Linolenic- and ?-Linolenic Acid-Enriched Diets.- Pathophysiology of Renal Failure in Shock: Role of Lipid Mediators.- Multiple Organ Failure, Liver Failure and Polyunsaturated Fat Metabolism.- Leukotrienes in Endotoxin Shock.- Time-Dependent Appearance of LTB4 in Human Burn Blisters.- Platelet-Activating Factor : An Inflammatory Mediator Involved in the Pathophysiology of Shock.- Mechanisms of Circulatory Collapse Induced by Paf-Acether.- Lipid Mediators in Lung Anaphylaxis : Kinetics of Their Release and Modulation by Selected Drugs.- A Role for Platelet Activating Factor in Shock and Acute Lung Injury.- Morphological and Pharmacological Evidences for the Participation of Paf-Acether in Anaphylactic Shock in the Guinea-Pig.- BiogenicAmines : Microcirculatory Aspects in Shock, Sepsis and Trauma.- Trypsin-Like Activity in Burn and Sepsis.- Significance of the Activation of the Kinin System Following Thermal Injury.- The Role of Lipid Mediators in Blood Fibrinolysis.- Fibrinolysis in Endotoxemia.- 3-The Immune Response in Critically Ill Patients.- Origins of Immunological Impairments in Burns.- Importance of Immune Function in Trauma for Survival.- Anergy in Critically Ill Patients.- Neural Release Mechanisms of the Injury Response.- Surgery and the Immune Response.- Immune Function and Severe Infection.- 4 - Mechanisms of Immune Response Impairment in Critically Ill Patients.- Interleukins: An Overview.- Cellular Immune Function and Injury.- Metabolic Mediators in Injury.- Mediators Affecting IL2 Function in Burn Immunosuppression.- T Cell Subpopulations Following Thermal Injury : Effect of the Acute Stress Response.- Natural Killer Cell Activity and Lymphocyte Function During and After Open-Heart Surgery in Relation to the Endocrine Stress Response.- Natural Killer Cell Activity During Epinephrine and Cortisol Infusion in Healthy Volunteers.- A Longitudinal Study of the Influence of Acute Myocardial Infarction on Natural Killer Cells.- Immune Depression and Sepsis Following Injury : The Role and Identity of Circulating Mediators.- Elective Immunosuppression.- Characterization of the Induction of Human Interleukin 1 by Endotoxins.- Human Endothelial Cells Produce Platelet Activating Factor in Response to Interleukin 1.- Interleukin 1 Stimulation of Vascular Endothelial Cell Adhesiveness for Leucocytes: in vitro and in vivo studies.- Systemic Alteration of Endothelial Cells in Shock.- Arterial Wall Reaction Following Electrical Local De-Endothelialization.- 5 - The Role of Lipid Mediators in the Immune Response.- The Role of Platelet Activating Factor in the Immune Response.- Leukotrienes in Lymphocyte Activation : Leukotriene B4, Enhances Interleukin 2 and Interferon-Gamma Production by Mitogen and A1loantigen-Stimulated Human T Cells.- Regulation of T Cell Activation by Leukotriene B4.- A Role for Platelet-Activating Factor (PAF) in Human T-Lymphocyte Proliferation.- 6 - New Drugs in Shock.- Lack of Effect of Cyclosporin A on Endogenous Arachidonic Acid Metabolism in Human Neutrophils.- Sulotroban (BM 13.177) and BM 13.505, Two TX-Receptor Blockers, Are Effective in Experimental Models of Ischaemia and Shock.- Ginkgo Biloba extracts Inhibits Oxygen Species Production Generated by Phorbol Myristate Acetate Stimulated Human Leukocytes.- The Coronary, Inotropic, Chronotropic and Arrhythmogenic Effects of PAF-Acether on Isolated Guinea-Pig Heart and Their Selective Inhibition by BN 52021.- The Effect of BW 755C on Would Healing in a Scald Burn Injury Pig Model-Morphological and Biochemical Findings.- A New Sonographic Model for Effective Quantification of Anti-Edematous and Antiinflammatory Drugs in Burns.