Editorial Response: Assaulting a Physiological Response

Should fever ever be suppressed? Fever is not a disease, nor is it necessarily an enemy. Fever is a physiological response to disease-one that many investigators believe to be an important defense mechanism. This belief is supported by numerous studies that were conducted during the second half of this century and demonstrated the beneficial effects of fever and/or its endogenous mediators on the outcome of a broad range of infectious diseases [1]. This belief is also consistent with the widespread distribution of the fever response within the animal kingdom, a finding intimating that fever has persevered throughout some 400,000,000 years of the evolutionary process [2]. Nevertheless, the gathering evidence that some of the endogenous mediators of the febrile response (namely, IL-1 and TNF-a) contribute to the pathophysiology of bacterial sepsis [3-10] and, perhaps, to the disability associated with a variety of other infectious diseases [3, 11-19] cannot be ignored. Unfortunately, although inhibitors of these mediators have been used with good effect in a variety of experimental infections, such therapy has not yet been shown to be beneficial in human infections [20].