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July 13, 1984

The Pathogenesis of Septic Shock-Reply

Author Affiliations

Bethesda, Md

JAMA. 1984;252(2):208. doi:10.1001/jama.1984.03350020018010

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In Reply.—  The letter by Drs Chernow and Holaday emphasizes the potential importance of endorphins in the pathogenesis of septic shock. In any review article of the type that we have written, different authors may emphasize some areas more strongly than others. As Drs Chernow and Holaday point out in their references, the bulk of information on the role of endorphins in septic shock has been derived from animal studies. Because we were writing for an audience of practicing physicians, we dealt mainly with human studies in our article. It may well be that in the future, endogenous opioid peptides will be found to be key, either directly or indirectly, in the development of septic shock; however, at the present time we do not feel that the available evidence warrants emphasizing the role of endorphins.