That colloids have greater hemodynamic effects, for a given fluid infusion volume, than crystalloids, even in sepsis with increased permeability and potential leakage selleckchem of the compounds, is corroborated by recent clinical observations .ConclusionThe outcome benefits and drawbacks of fluid resuscitation in sepsis and shock may not solely relate to hemodynamic effects, so that more is not always better, even if overt overhydration and (pulmonary) edema do not occur. The experimental findings remind us that outcome may also be a matter of the type of fluid used for initial resuscitation during septic shock. Obviously, this relates, among other factors, to the increasing evidence that starch solutions have important side effects, particularly when exceeding recommended maximum daily doses.
Further comparative research is needed.Competing interestsThe author declares that they have no competing interests.NotesSee related research by Brandt et al., http://ccforum.com/content/13/6/R186
There is accumulating evidence indicating that regulatory T cells (Tregs) play important roles in the maintenance of immunologic self-tolerance and in down-regulation of various immune responses . Tregs have been shown to be important in regulating the immune responses in transplant rejection, tumor immunity, infectious diseases and allergy. Thus, there has recently been an increasing interest in investigating the biology of Tregs as well as its potential application in the treatment of immunity relevant illnesses.Many types of Treg subsets have been reported in a variety of morbid conditions.
It is now clear that immune regulatory cells consist of many distinct T cell subsets . Among them, CD4+ Tregs have been demonstrated in a wide range of animal models and in humans [3,4], and the forkhead/winged helix transcription factor p3 (FOXP3) has been suggested to represent a reliable intracellular marker for naturally occurring Tregs . Most studies on CD4+ Tregs use a combination of CD25, cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), FOXP3, IL-10 and/or transforming growth factor-��1 (TGF-��1) to define Treg populations .The stress response to burn injury is similar to that of severe trauma or critical illness but differs in its severity and duration. The inflammatory GSK-3 response is triggered immediately after thermal injury and persists for almost five weeks postburn . Superimposed severe infections can result in the suppression of one or more functions of the host immune system after major burns.