The American journal of medicine
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Progressive multiple organ failure in association with septic complications in the surgical, trauma and burn patient is of major clinical importance. Reticuloendothelial system host defense mechanisms are abnormal following severe trauma and burn. Failure in systemic host defense is, in part, mediated by a deficiency in a circulating opsonic alpha 2 surface binding (SB) glycoprotein. ⋯ Cell surface fibronectin which participates in cell adhesion may, in part, modulate microvascular integrity, vascular permeability and would repair. In contrast, the more soluble plasma fibronectin or opsonic alpha 2SB glycoprotein may mediate reticuloendothelial clearance of blood-borne particulates to prevent pulmonary and peripheral vascular microembolization and organ injury. Thus, reversal of opsonic deficiency may be an effective modality of therapy in the septic injured patient with organ failure.