Journal Article

Circulating Cytokines as Mediators of Fever

Mihai G. Netea, Bart Jan Kullberg and Jos W. M. Van der Meer

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 31, issue Supplement_5, pages S178-S184
Published in print October 2000 | ISSN: 1058-4838
Published online October 2000 | e-ISSN: 1537-6591 | DOI:
Circulating Cytokines as Mediators of Fever

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The febrile response is thought to be mediated by endogenous mediators, generically called “endogenous pyrogens.” In the classical model of pathogenesis, induction of fever is mediated by the release of pyrogenic cytokines such as tumor necrosis factor (TNF), interleukin (IL)-1, IL-6, and interferons into the bloodstream in response to exogenous pyrogens. These mediators act at the level of the organum vasculosum of the lamina terminalis in the central nervous system (CNS), inducing synthesis of prostaglandins, which are the central mediators of the coordinated responses leading to fever. However, analysis of recent data suggests that multiple pathways may be involved in the induction of fever by cytokines, such as local cytokine production leading to signaling through vagal fibers, release of cytokine-induced circulating mediators at the tissue level, the use of membrane-bound cytokines as mediators, or the local release of cytokines in the hypothalamus by circulating activated monocytes. In addition, certain bacterial products can stimulate cytokine production directly at the level of hypothalamus, probably by activation of Toll-like receptors. A multipathway mechanism for the induction of fever is therefore suggested.

Journal Article.  5238 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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