CME: Sepsis Pathogenesis - Host factors
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Transcript of CME: Sepsis Pathogenesis - Host factors
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By:
Dr JAMI SWATHI
Under the guidance of Prof Dr CHENTHIL
SEPSIS
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PATHOGENESIS-
HOST DERIVED MECHANISMS
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WHAT IS SEPSIS???.....
Sepsis is the systemic maladaptive response of the host organism to the invasion of normally sterile tissue, fluid or body cavity by pathogenic or potentially pathogenic microorganisms
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HOST RESPONSE
Recruitment of inflammatory cells
Cytokine release
Activation of coagulation system
Neutrophil- endothelial cell interactions
Role of Nitric Oxide
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RECRUITMENT OF INFLAMMATORY CELLS
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CYTOKINES
Pro inflammatory cytokines: predominate in the early phases of sepsis
Anti inflammatory cytokines: prevail in the later phase
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ROLE OF LYMPHOCYTES
Participate mainly in the late phase of sepsis
Play a role in the production of both pro inflammatory & anti- inflammatory cytokines
CD4 lymphocytes play a major role
Outcome of sepsis depends nature of the lymphocyte response (expression of Th1 or Th2)
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COAGULATION SYSTEM Extrinsic pathway is predominantly activated
activation of intravascular coagulation results in microthrombi formation
multi organ failure
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NEUTROPHIL- ENDOTHELIAL CELL INTERACTIONS
• Neutrophil activation & degranulation exposes the endothelium to reactive O2
species, NO & proteases
• leads both to microbial clearance & diffuse endothelial injury
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NITRIC OXIDESynthesized in the presence of TNF-α, IL-1,
LPS
Initiates vasodilatation
Responsible for increased neutrophil and platelet adherence
Intracellular killing
Lipid peroxidation
Enzyme inhibition
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THANK YOU