Cellular-molecular mechanisms in the development of peritonitis

Abstract

Introduction: Peritonitis is an inflammatory process involving cells, a synthesis of proinflammatory mediators (IL-6, TNF-a) and anti-inflammatory (IL-10, IL-27), which maintain inflammation. The cellular-molecular mechanisms that determine the evolution and prognosis of peritonitis are not fully elucidated. Purpose: Study of the evolutions of cellulo-molecular changes at the level of peritoneum and blood, in correlation with the pathogen. Identification of new methods of diagnosis and treatment in peritoneal sepsis. Material and Methods: The current references from the international scientific literature were examined, implicitly the databases of the electronic libraries PubMed, GeneCards and Annals of Translational Medicine. Results: Peritonitis is an inflammatory process that goes through 2 antagonistic stages - hyperinflammation and hypoinflammation (immunoparalysis) fig. 1, and as in any inflammation it goes through several cycles. At each stage some specific interleukins are secreted, depending on this the condition of the organism, the prognosis and the adequate treatment can be diagnosed.The cytokine storm triggered in peritonitis is interdependent with the pathogen, in table no. 1 with specific biomarkers, for some infections.So far it is not a specific biomarker to indicate the severity of inflammation and its prognosis, but a precursor of adrenomodulin has been found, it is the most sensitive according to the severity of sepsis, which is a help for ICU, table no.2.