Системный воспалительный ответ и апоптоз в патогенезе пост-травматической полиорганной недостаточности

Multiple organ dysfunction (MOD) is the most frequent cause of late posttraumatic lethality. Massive injury leads to activation of the immune system and the inflammatory immune response after trauma has been defined as systemic inflammatory response syndrome (SIRS). SIRS can lead to tissue destruction in organs not originally affected by the initial trauma with subsequent development of MOD. The biochemical and cell biological basis for organ dysfunction per se remains very poorly understood. The theory that apoptosis contributes to the multiple organ dysfunction was formulated originally by Bone in 1996. The argument has been proposed that certain immunomodulatory factors which present in overwhelming amounts in SIRS could contribute to a generalized systemic increase in cellular apoptosis, which, in turn, promotes organ failure. The scientific data on the role of systemic inflammatory response and apoptosis in the pathogenesis of posttraumatic MOD is summarized in the review.