Leukocytemediated injury

Primary injury of either the gut or the lungs results in a leukocyte-mediated increase in permeability in the other organ, as described above. Multiple or sequential insults translate this into clinically evident organ injury and increased mortality. Other organs will be affected by the same process, although evidently there are many factors which determine the precise pattern of organ involvement and the reasons for certain organs being spared or involved. Once activated neutrophils migrate from the vascular space, they are able to release their intracellular contents, which include hypochlorous acid and other reactive oxygen species, causing cellular injury. Lymphocytes may also be involved either in their role as memory cells, documenting and responding to foreign antigen, or in direct response to intracellular infection. Unlike neutrophils, lymphocytes recirculate via the lymphatics; they also secrete many cytokines which may enhance or inhibit the immune response.

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