Document Detail


Recombinant antithrombin attenuates pulmonary inflammation following smoke inhalation and pneumonia in sheep.
MedLine Citation:
PMID:  12576969     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The interaction between coagulation and inflammation has become one of the major topics in critical care medicine. In the present study, we investigated the effect of posttreatment of sepsis with recombinant human antithrombin. DESIGN: Experimental laboratory in a university hospital. SETTING: University laboratory. SUBJECTS: Female merino ewes (n = 16). INTERVENTIONS: After 1 wk of recovery from the surgical preparation, a tracheotomy was performed followed by insufflation of 48 breaths of cotton smoke (<40 degrees C). Afterward, a stock solution of live (5 x 10(11) colony-forming units) was instilled in the both lung lobes through a bronchoscope. All sheep were mechanically ventilated employing 100% oxygen. An infusion of recombinant human antithrombin (100 units x kg(-1) x 24 hrs(-1), intravenously; n = 6) or saline (n = 6) was started 1 hr after injury. Sham control animals (n = 4) were surgically prepared but not insufflated with smoke and bacteria. Lung histologic changes were evaluated by a scoring system. MEASUREMENTS AND MAIN RESULTS: The infusion of recombinant human antithrombin maintained the baseline antithrombin activity throughout the study; in the saline-treated group, antithrombin activity decreased significantly. The lung wet/dry weight ratio and the histology score (combined scores for congestion, edema, inflammation, and hemorrhage) were significantly increased by the insult, but recombinant human antithrombin attenuated these responses. More than 30% of both bronchi and bronchioles were obstructed by cast formation after smoke inhalation and pneumonia. The cast was composed of epithelial cells, neutrophils, mucus, and fibrin. The obstruction was significantly improved by recombinant human antithrombin infusion. Arterial pressure and urine output were also attenuated in recombinant human antithrombin-treated animals. The increases in plasma nitrate/nitrite concentrations and pulmonary shunt fraction after the injury were not attenuated by recombinant human antithrombin. CONCLUSION: Posttreatment by recombinant human antithrombin was effective in treating acute lung injury after smoke inhalation and pneumonia in sheep. We hypothesize that the decrease in antithrombin activity during sepsis might induce severe airway obstruction and that supplementation with antithrombin inhibits this decrease.
Authors:
Kazunori Murakami; Roy McGuire; Robert A Cox; Jeffrey M Jodoin; Frank C Schmalstieg; Lillian D Traber; Hal K Hawkins; David N Herndon; Daniel L Traber
Related Documents :
22860999 - Aerosolized delivery of oxime mmb-4 in combination with atropine sulfate protects again...
7842209 - Modulation of airway intraepithelial dendritic cells following exposure to steroids.
697179 - Bronchial hyperirritability in healthy subjects after exposure to ozone.
20303939 - Effect of cyclic amp-elevating agents on airway ciliary beat frequency in central and l...
1916079 - Chronic exposure to a simulated urban profile of ozone alters ventilatory responses to ...
23490179 - Neurobehavioral effects, c-fos/jun expression and tissue distribution in rat offspring ...
21554589 - Adrenocorticotropin release induced by n-methyl-d-aspartate or stress: mediation by the...
2089199 - Determination of levels of biogenic amines and their metabolites and both forms of mono...
8484889 - Effects of amygdala central nucleus lesions on blocking and unblocking.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Critical care medicine     Volume:  31     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-02-10     Completed Date:  2003-03-25     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  577-83     Citation Subset:  AIM; IM    
Affiliation:
University of Texas Medical Branch and Shriners Burns Hospital, Galveston 77555-0833, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Animals
Antithrombins / therapeutic use*
Female
Pneumonia / drug therapy*,  physiopathology
Recombinant Proteins / therapeutic use
Sheep
Smoke Inhalation Injury / drug therapy*,  physiopathology
Grant Support
ID/Acronym/Agency:
GM60688/GM/NIGMS NIH HHS
Chemical
Reg. No./Substance:
0/Antithrombins; 0/Recombinant Proteins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Should vasopressin replace adrenaline for endotracheal drug administration?
Next Document:  Increases in spinal fluid osmolarity induced by mannitol.