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EN
NO mediates many systemic reactions in humans and animals. It is produced by constitutive synthases (cNOS) and one inducible by cytokines and endotoxines (iNOS). We summarize, on the base of experimental and clinical data, the pathophysiological role of NO in septic shock as well as the effects of pharmacological application of NOS inhibitors. The analysed data show, that the contribution of NO to the pathomechanism of septic shock is rather heterogenous, therefore the clinical therapeutical application of selective iNOS inhibitors is impossible without adequate new monitoring tools.
EN
Septic shock is the most severe manifestation of infection and appears to be increasingly common, especially in the intensive care units. Lipopolisaccharides (LPS, endotoxin) are known to be responsible for the initiation of sepsis and septic shock, therefore they can be targets for new preventive and therapeutic strategies. This review focuses on endotoxin-based molecular strategies for the prevention and treatment of Gram-negative sepsis and septic shock.
EN
The first stage of systemic inflammatory response during sepsis and septic shock is the massive production of proinflammatory cytokines. Numerous clinical trials were done investigating various agents that were thought to stop this reaction. The results, however, were disappointing. Then it was realised that massive production of antiinflammatory cytokines could also be delirious. Persistent immunosupression in the course of sepsis increaased the risk of death. Therefore the proper balance between pro- and antiinflammatory mediators is extremely important and the methodologies available for monitoring immunological status in patients with sepsis and septic shock are currently of great interest.
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