Does programmed cell death (apoptosis) play a role in the development of multiple organ dysfunction in critically ill patients? A review and a theoretical framework

Abstract

The most important MODS-related pathophysiologic conditions known to date have been shown to affect programmed cell death rates in almost all cell types. Organ-specific cell death involving both parenchymal and microvasculature endothelial cells is conceivably underlying organ dysfunction. The hypothesis that increased apoptotic rates are involved in organ dysfunction may provide a unifying theory for the pathophysiology of MODS.

Synergistic Effect of Influenza A Virus on Endotoxin-Induced Mortality in Rat Pups: A Potential Model for Sudden Infant Death Syndrome

“…Organspecific cell death with increased apoptotic rates and thymic stress changes, as seen in our model, are common pathologic findings (34,43). It has been suggested that NO is responsible for some of the organ damage described in autopsy reports of infants dying of SIDS (44) 488 iNOS and NO are also a part of the immune response to viral infection (45).…”

Plasma Interleukin-8 as a Potential Predictor of Mortality in Adult Patients with Severe Traumatic Brain Injury

“…Even in case of moderate brain injury, prompt expression of mRNA of cytokines, chemokines and adhesion molecules was found (Pratschke et al 2000). It is speculated that these events eventually lead to dysregulation of apoptosis (Papathanassoglou et al 2001), which plays important role in multiple organ dysfunction syndrome (MODS). In favor of this are experimental findings of effectiveness of antiinflammatory therapy for severe brain injury that was beneficial for cardiac consequences of brain trauma (Emir et al 2005).…”

Lipopolysaccharide Induces Rapid Production of IL-10 by Monocytes in the Presence of Apoptotic Neutrophils

“…It has been suggested that inhibition of lymphocyte apoptosis might be an effective therapeutic target in sepsis (68,69). However, it would now appear that a fuller understanding is needed of the specific role played by each of these two apoptotic cell types in the regulation of IL-10 and proinflammatory cytokine production before targeting one alone (70).…”