Cytokine Responses in Secondary Peritonitis

The onset of local and systemic inflammatory effects in secondary peritonitis is usually closely related to the presence of many inflammatory mediators such as cytokines. The main purpose of this paper is to review the mechanisms induced by secondary peritonitis related to the production of cytokines, to determine their role in the onset of local inflammatory responses and in the onset of systemic inflammatory responses leading to multiple organ failure. We also review the immunomodulatory effects induced by cytokine production and their counteraction. Finally we analyze the potential therapeutic effects of cytokine-related drugs and their role in the management of patients with secondary peritonitis and systemic inflammatory response syndrome. In this regard the following substances are important: nonspecific immunomodulators, anti-cytokine antibodies, and inhibitors of the cytokine effect and of adhesion molecules.