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  1. cytokines are small proteins that regulate immune, inflammatory, and hematopoietic processes produced by monocytes, neutrophils, and lymphocytes
  2. in general, cytokines exert their effects by influencing gene activation that results in cellular activation, growth, differentiation, functional cell surface molecule expression, and cellular effector function
  3. pyrogenic cytokines – IL-1, IL-6, tumor necrosis factor (TNF) and interferon (IFN)
    1. IL-1 is the primary interleukin responsible for fever
    2. IL-6 is responsible for B cell proliferation and hepatocyte stimulation
    3. TNF-alpha is primarily produced by mononuclear phagocytes and causes hypotension and diffuse capillary leak when infused in animals
    4. when macrophages and astrocytes are exposed to endotoxins in vitro, the cells synthesize and release cytokines the most important of which are interleukin 1 (IL-1) and tumor necrosis factor (TNF) which stimulate and modulate the local immune response
    5. glial and possibly neuronal cells synthesize IL-1, IL-6, and TNF
  4. IL-6,8,10 are elevated in injury
  5. Thromboxane A2, prostacyclin and the leukotrienes are all derived from arachidonic acid
  6. C-reactive protein enhances opsonin phagocytosis and activates complement
  7. Interferon gamma is located on chromosome 12 and enhances oxidative burst and microbial killing activity of macrophages
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