Invited Commentary

Arthur E. Baue, MD
Arch Surg. 1997;132(5):539. doi:10.1001/archsurg.1997.01430290085017.
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The MODS that progresses to multiple-organ failure is a serious problem for patients who undergo surgical procedures. Once multiple-organ failure develops, the mortality rate is high. Thus, information about the factors that are involved in producing this problem will eventually be beneficial for our patients. In this issue of the Archives, Nieuwenhuijzen and coworkers provide important information about macrophage activity in various organs (eg, the liver and spleen, the lungs [alveolar macrophages], and peritoneal cavity). Macrophages in these organs or locations were destroyed by liposomes that contained a toxic agent. Then, the experimental animals were challenged by IP zymosan, which is an agent that produces a severe inflammatory reaction. Goris and colleagues1,2 have previously shown that zymosan-induced inflammation produces MODS or multiple-organ failure.

In the present study, elimination of alveolar macrophages prevented deaths caused by peritoneal inflammation, whereas elimination of peritoneal macrophages increased the zymosan-associated mortality rate. The elimination


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