Basis of the general theory of pathology (Part 3. Sepsis as an adaptive protective response of organism)

Abstract

A problem of the essence of sepsis remains unresolved. Sepsis isseen as inadequate, insufficient, or perverted body's response to microbial invasion. The authors analyze the problem of sepsis from the opposite (paradoxical) position based on the well-known postulate that any pathological process (disease) is an adaptation i. e. a protective mechanism. The authors describe known antimicrobial protective barriers ("physiological" and "pathological") and determine a role of different variants of sepsis in protective reactions of human body. The article describes the nature and mechanisms of adaptation under the different variants of sepsis: Wissler – Fanconi’ssubsepsis, intravascular infection, septicopyemia, septicemia and septic shock. These mechanisms might form the basis of pathogenetic therapy. The authors believe that a degree of effectiveness of "pathological" protection of the internal environment is determined by time, i. e. by a duration of a protective effect. In the launch of a septic reaction an important role belongs to a massive invasion of microorganisms into the internal environment of a host by unnatural way – bypassing protective barriers created by evolution. Thus, from the authors' point of view, sepsis is a general pathological process ("pure" infection). Sepsis is a non-specific adaptive (defensive) reaction of human body to a massive microbial invasion.