Articles: sepsis.
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Comparative Study
Quantification of plasma factor XIIa-Cl(-)-inhibitor and kallikrein-Cl(-)-inhibitor complexes in sepsis.
Considerable evidence indicates that activation of the contact system of intrinsic coagulation plays a role in the pathogenesis of septic shock. To monitor contact activation in patients with sepsis, we developed highly sensitive radioimmunoassays (RIAs) for factor XIIa-Cl(-)-inhibitor (Cl(-)-Inh) and kallikrein-Cl(-)-Inh complexes using a monoclonal antibody (MoAb Kok 12) that binds to a neodeterminant exposed on both complexed and cleaved Cl(-)-Inh. Plasma samples were serially collected from 48 patients admitted to the intensive care unit because of severe sepsis. ⋯ No significant differences in plasma kallikrein-Cl(-)-Inh or prekallikrein antigen were found between these patients' groups. Elevated Cl(-)-Inh complex levels were measured less frequently in serial samples from patients with septic shock than in those from patients without shock (P less than .0001). Based on these results, we conclude that plasma Cl(-)-Inh complex levels during sepsis may not properly reflect the extent of contact activation.
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Scand. J. Clin. Lab. Invest. · Dec 1988
Comparative StudyElevated levels of plasma hyaluronan in septicaemia.
Hyaluronan (hyaluronic acid) is normally rapidly cleared from the circulation by the endothelial cells in the liver sinuoids, which make up part of the reticulo-endothelial system (RES). An impaired RES function in severe infection and sepsis might therefore lead to elevated hyaluronan plasma levels. Thus, plasma concentrations of hyaluronan were analysed in 44 patients with severe infection at onset of disease and twice during the following 2-3 days. ⋯ Septic shock, and especially fatal septic shock, thus appears to be associated with elevated plasma hyaluronan concentrations. Possible mechanisms might be an increased release of the polysaccharide from the interstitial space to the bloodstream, or a decreased rate of clearance by liver endothelial cells. This question demands further study.