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The role of C5a in acute lung injury induced by highly pathogenic viral infections. Emerg Microbes Infect 2015; 4:e28. [PMID: 26060601 PMCID: PMC4451266 DOI: 10.1038/emi.2015.28] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 03/12/2015] [Accepted: 03/31/2015] [Indexed: 12/14/2022]
Abstract
The complement system, an important part of innate immunity, plays a critical role in pathogen clearance. Unregulated complement activation is likely to play a crucial role in the pathogenesis of acute lung injury (ALI) induced by highly pathogenic virus including influenza A viruses H5N1, H7N9, and severe acute respiratory syndrome (SARS) coronavirus. In highly pathogenic virus-induced acute lung diseases, high levels of chemotactic and anaphylatoxic C5a were produced as a result of excessive complement activaiton. Overproduced C5a displays powerful biological activities in activation of phagocytic cells, generation of oxidants, and inflammatory sequelae named "cytokine storm", and so on. Blockade of C5a signaling have been implicated in the treatment of ALI induced by highly pathogenic virus. Herein, we review the literature that links C5a and ALI, and review our understanding of the mechanisms by which C5a affects ALI during highly pathogenic viral infection. In particular, we discuss the potential of the blockade of C5a signaling to treat ALI induced by highly pathogenic viruses.
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Al-Hadithy N, Zoumot Z, Parida S, Barlow A. PantonâValentine leukocidin pneumonia: an emerging threat. CLINICAL RESPIRATORY JOURNAL 2010; 4:61-4. [DOI: 10.1111/j.1752-699x.2009.00150.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Koh H, Tasaka S, Hasegawa N, Yamada W, Shimizu M, Nakamura M, Yonemaru M, Ikeda E, Adachi Y, Fujishima S, Yamaguchi K, Ishizaka A. Protective role of vascular endothelial growth factor in endotoxin-induced acute lung injury in mice. Respir Res 2007; 8:60. [PMID: 17718922 PMCID: PMC2042500 DOI: 10.1186/1465-9921-8-60] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2007] [Accepted: 08/25/2007] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Vascular endothelial growth factor (VEGF), a substance that stimulates new blood vessel formation, is an important survival factor for endothelial cells. Although overexpressed VEGF in the lung induces pulmonary edema with increased lung vascular permeability, the role of VEGF in the development of acute lung injury remains to be determined. METHODS To evaluate the role of VEGF in the pathogenesis of acute lung injury, we first evaluated the effects of exogenous VEGF and VEGF blockade using monoclonal antibody on LPS-induced lung injury in mice. Using the lung specimens, we performed TUNEL staining to detect apoptotic cells and immunostaining to evaluate the expression of apoptosis-associated molecules, including caspase-3, Bax, apoptosis inducing factor (AIF), and cytochrome C. As a parameter of endothelial permeability, we measured the albumin transferred across human pulmonary artery endothelial cell (HPAEC) monolayers cultured on porous filters with various concentrations of VEGF. The effect of VEGF on apoptosis HPAECs was also examined by TUNEL staining and active caspase-3 immunoassay. RESULTS Exogenous VEGF significantly decreased LPS-induced extravascular albumin leakage and edema formation. Treatment with anti-VEGF antibody significantly enhanced lung edema formation and neutrophil emigration after intratracheal LPS administration, whereas extravascular albumin leakage was not significantly changed by VEGF blockade. In lung pathology, pretreatment with VEGF significantly decreased the numbers of TUNEL positive cells and those with positive immunostaining of the pro-apoptotic molecules examined. VEGF attenuated the increases in the permeability of the HPAEC monolayer and the apoptosis of HPAECs induced by TNF-alpha and LPS. In addition, VEGF significantly reduced the levels of TNF-alpha- and LPS-induced active caspase-3 in HPAEC lysates. CONCLUSION These results suggest that VEGF suppresses the apoptosis induced by inflammatory stimuli and functions as a protective factor against acute lung injury.
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Affiliation(s)
- Hidefumi Koh
- Division of Pulmonary Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Sadatomo Tasaka
- Division of Pulmonary Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Naoki Hasegawa
- Division of Pulmonary Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Wakako Yamada
- Division of Pulmonary Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Mie Shimizu
- Division of Pulmonary Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Morio Nakamura
- Division of Pulmonary Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Makoto Yonemaru
- Division of Pulmonary Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Eiji Ikeda
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Yoshiyuki Adachi
- Laboratory of Immunopharmacology of Microbial Products, Tokyo University of Pharmacy and Life Science, Tokyo, Japan
| | - Seitaro Fujishima
- Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kazuhiro Yamaguchi
- Division of Pulmonary Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Akitoshi Ishizaka
- Division of Pulmonary Medicine, Keio University School of Medicine, Tokyo, Japan
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Ochiai J, Takano H, Ichikawa H, Naito Y, Yoshida N, Yanagisawa R, Yoshino S, Murase H, Yoshikawa T. A novel water-soluble vitamin E derivative, 2-(alpha-D-glucopyranosyl)methyl-2,5,7,8-tetramethylchroman-6-ol, protects against acute lung injury and mortality in endotoxemic rats. Shock 2002; 18:580-4. [PMID: 12462569 DOI: 10.1097/00024382-200212000-00016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Satisfactory therapy for acute lung injury related to endotoxemia remains to be established. However, in vivo antioxidant treatment with N-acetylcysteine reportedly suppresses acute lung injury and proinflammatory cytokine production induced by endotoxin (lipopolysaccharide, LPS). In addition, intrinsic vitamin E is protective against LPS-induced insults. We determined the effects of a novel water-soluble vitamin E derivative, 2-(alpha-D-glucopyranosyl)methyl-2,5,7,8-tetramethylchroman-6-ol (TMG), on acute lung injury and mortality induced by LPS in rats. Intravenous injection of TMG (4 or 40 mg/kg) effectively decreased mortality and prevented the increased alveolar permeability and pulmonary edema that were caused by intravenous injection of LPS (20 mg/kg). Treatment with TMG decreased the enhanced lung expression of TNF-alpha caused by LPS. TMG also suppressed the sequestration of neutrophils in the lung induced by LPS. These results indicate that TMG is a possible therapeutic agent for acute lung injury and mortality, especially that caused by gram-negative bacteria. The therapeutic effects could be mediated at least partly through suppression of the increased expression of TNF-alpha and neutrophil sequestration in the lung that are caused by LPS.
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Affiliation(s)
- Jun Ochiai
- First Department of Medicine, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto 602-8566, Japan
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Yonemaru M, Kasuga I, Kusumoto H, Kiyokawa H, Kuwabara S, Ichinose Y, Toyama K. Protein kinase inhibitor attenuates an increase in endothelial monolayer permeability induced by tumour necrosis factor-alpha. Respirology 1997; 2:63-9. [PMID: 9424406 DOI: 10.1111/j.1440-1843.1997.tb00055.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We questioned the mechanism of the increase in pulmonary endothelial permeability induced by tumour necrosis factor-alpha (TNF-alpha), a cytokine implicated in the pathogenesis of adult respiratory distress syndrome. As a measure of permeability, we determined the albumin transferred across cultured pulmonary endothelial monolayers prepared on a porous filter. The agents evaluated included protein kinase inhibitors H-7 and H-8, a calmodulin antagonist W-7, and protein kinase C (PKC) activators, phorbol myristate acetate (PMA) and SC-9. H-7, more potent in inhibiting PKC than H-8, failed to attenuate the increase in permeability induced by TNF-alpha. Neither PMA nor SC-9 increased permeability. However, H-8, which is a potent inhibitor of cyclic nucleotide-dependent protein kinases, prevented the increase in permeability induced by TNF-alpha. These results suggest that protein kinase other than PKC are involved in the signal transduction in endothelial permeability increase induced by TNF-alpha. Calmodulin pathway may not be implicated in the increase in permeability induced by TNF-alpha.
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Affiliation(s)
- M Yonemaru
- First Department of Internal Medicine, Tokyo Medical College, Japan
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Cernak I, Savic J, Malicevic Z, Zunic G, Radosevic P, Ivanovic I. Leukotrienes in the pathogenesis of pulmonary blast injury. THE JOURNAL OF TRAUMA 1996; 40:S148-51. [PMID: 8606397 DOI: 10.1097/00005373-199603001-00032] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Our previous studies demonstrate a significant increase of sulfidopeptide leukotriene concentrations in animals exposed to a free air blast. The aim of this study was to analyze the role of leukotrienes in the local response of lung tissue as well as in the general response of organisms to blast overpressure. The study was conducted on adult rabbits exposed to moderate blast overpressure (four pulmonary contusions characterized as confluent ecchymoses involving 30 to 60% of the lungs), generated in laboratory conditions. One group of experimental animals was treated with 5-lipoxygenase (5-LO) inhibitor, diethylcarbamazine (DEC, Sigma, St. Louis, Missouri) (50 mg/kg, i.v.), immediately before blast. The early posttraumatic period was observed (30 minutes after blast). Hemodynamic parameters (mean arterial pressure, heart rate, blood gases) as well as arterial plasma levels of conjugated dienes were observed. The myeloperoxidase activity, lipid peroxidation products levels, and water contents were measured in the lung tissue of injured rabbits. We observed that 5-LO inhibition reduced edema formation, accumulation of neutrophils, and generation of lipid peroxidation products in injured lungs. In this study, we demonstrated that treatment with DEC inhibits the increased systemic generation of conjugated dienes after blast injury. Although DEC exerts local antioxidant activity with beneficial effects on lung tissue, this 5-LO inhibitor intensifies the blast overpressure caused hemodynamic insufficiency.
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Affiliation(s)
- I Cernak
- Military Medical Academy, Institute for Medical Research, Beograd, Yugoslavia
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Malmros C, Holst E, Hansson L, Mårtensson L, Thörne J. Dynamic accumulation of neutrophils in lungs and visceral organs during early abdominal sepsis in the pig. World J Surg 1994; 18:811-6; discussion 816-7. [PMID: 7846901 DOI: 10.1007/bf00299071] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Activation and accumulation of polymorphonuclear leukocytes (PMNs, neutrophils) in the lungs is considered an important mechanism in the pathogenesis of pulmonary dysfunction in association with sepsis. It probably constitutes only part of a general cellular response; and a corresponding reaction has been implicated in other organs during sepsis (e.g., the liver). In this experiment a model was developed that allows study of the dynamic PMN reaction in the lungs and visceral organs during early abdominal sepsis. The animals were divided into two groups. In the septic group (n = 8) a bacterial challenge was attempted through the intraperitoneal administration of Escherichia coli (1 x 10(11)/kg). Five animals served as controls. All animals in the septic group developed bacteremia, leukopenia, and a hypodynamic circulatory response. PMNs were selectively labeled with 111In-oxine. The activity over the organs was followed dynamically with a gamma camera. The animals subjected to peritonitis exhibited a significant increase in 111In-oxine activity (i.e., neutrophil trapping) in the lungs, compared to the controls at 40 minutes and onward during the observation period. A similar picture was seen over the liver and abdomen, with significance after 70 minutes. The findings in this study indicate that accumulation of PMNs is an early phenomenon not only in the lungs but also in the liver during the development of sepsis. The present model offers possibilities for further studies of the cellular reactions during sepsis.
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Affiliation(s)
- C Malmros
- Department of Anesthesiology, University Hospital, University of Lund, Sweden
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Torre D, Minoja G, Maraggia D, Chiaranda M, Tambini R, Speranza F, Giola M. Effect of recombinant IL-1 beta and recombinant gamma interferon on septic acute lung injury in mice. Chest 1994; 105:1241-5. [PMID: 8162754 DOI: 10.1378/chest.105.4.1241] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The effect of recombinant human interleukin 1B (IL-1B) and recombinant human gamma interferon (IFN-g), when given prophylactically, in a mouse model of septic acute lung injury was studied. Mice were treated with various doses of IL-1B and IFN-g for 3 consecutive days prior to administration of lipopolysaccharide of Escherichia coli (1 mg/kg given intraperitoneally). To determine the histologic changes occurring after prophylactic administration of such cytokines, a scoring system was assessed. A significant reduction of edema and neutrophil accumulation into the lungs of mice was observed, especially at doses of 100 U per mouse and 10,000 U per mouse of IL-1B and IFN-g, respectively. Prophylactic administration of IL-1B or IFN-g caused histologic changes, including marked reduction of edema and neutrophil accumulation in the interstitial and alveolar spaces. Combined prophylactic administration of IL-1B and IFN-g provoked a marked decrease of neutrophil accumulation into the lungs, but was not accompanied by significant reduction of edema or hemorrhage. These results provide evidence for the beneficial role of IL-1B and IFN-g in the abnormality of septic acute lung injury by reducing inflammatory lesions.
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Affiliation(s)
- D Torre
- Division of Infectious Diseases, Regional Hospital, Varese, Italy
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Töns C, Klosterhalfen B, Klinge U, Kirkpatrick CJ, Mittermayer C, Schumpelick V. [Septic shock and multiple organ failure in surgical intensive care. An animal experiment model on the analysis of pulmonary and intestinal dysfunction]. LANGENBECKS ARCHIV FUR CHIRURGIE 1993; 378:217-32. [PMID: 7690106 DOI: 10.1007/bf00184364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The study deals with an animal model for the problems of surgical intensive care patients. Following repeated applications of E. coli endotoxin WO 111:B4 under standard conditions, specific hemodynamic and biochemical (TNF, TXA2, PGI2, IL-6, PAF) and morphological (endothelium of the lung) alterations were detected. ARDS patterns induced by the sepsis were analyzed by high-frequency measurement of pressure and flow (385 measurements per breathing cycle). The role of the intestine in sepsis was investigated by ion-selective monitoring of surface potassium activity comparing mucosa and serosa. Every injection of endotoxin was followed by a selective increase of the potassium activity revealing relative ischemia induced by the endotoxin. The profile of the potassium levels on the surface correlates both with the cardiac output and with the prostacyclin levels. The continuous narrowing of the difference between mucosa and serosa, potassium during the period of investigation can be regarded as evidence for pathologic change in permeability fostering the septic course.
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Affiliation(s)
- C Töns
- Chirurgische Klinik, RWTH Aachen
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11
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Luyt DK, Richards GA, Roode H, Dowdeswell RJ, van Rensburg AJ, Reinach SG. Thalassemia: lung function with reference to iron studies and reactive oxidant status. Pediatr Hematol Oncol 1993; 10:13-23. [PMID: 8443047 DOI: 10.3109/08880019309016523] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Pulmonary function tests were performed in 15 thalassemic patients (age 5 years 8 months to 18 years 6 months), receiving both regular transfusions and desferrioxamine, to determine the presence and nature of any abnormalities in lung function. Reactive oxidant production from neutrophils was measured simultaneously to ascertain if a causal relationship existed between free radical production and tissue damage in the lungs. Mean total lung capacity, mean residual volume, and mean forced vital capacity were significantly reduced, indicating a restrictive pattern of lung function abnormality. In addition, the carbon monoxide diffusion was low, and hypoxemia was present in 6 of 13 patients tested. These pulmonary function abnormalities did not correlate with age, cumulative volume of transfusion, or serum ferritin levels. In addition, neutrophil reactive oxidant status did not correlate with these or with pulmonary function parameters. These results indicate that neutrophil-derived oxygen free radicals do not appear to be a major cause of lung function abnormalities in thalassemics.
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Affiliation(s)
- D K Luyt
- Department of Pediatrics, Coronation Hospital, Johannesburg, South Africa
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Abstract
Adult respiratory distress syndrome (ARDS) is an increased permeability pulmonary edema syndrome known to be associated with a variety of direct and indirect pulmonary insults. ARDS occurred in a 37-year-old woman during an episode of epiglottitis. The patient was treated with endotracheal intubation and mechanical ventilation and recovered, to be discharged from the hospital 1 week after presentation. There are only two cases of ARDS reported in this setting, and in each case, pulmonary edema followed cardiac arrest and the patients had a fatal outcome.
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Affiliation(s)
- G L Sternbach
- Emergency Department, Seton Medical Center, Daly City, CA 94015
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13
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Kondoh Y, Taniguchi H, Taki F, Takagi K, Satake T. 7S collagen in bronchoalveolar lavage fluid of patients with adult respiratory distress syndrome. Chest 1992; 101:1091-4. [PMID: 1555426 DOI: 10.1378/chest.101.4.1091] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
To evaluate the disruption of the basement membrane in the pathogenesis of adult respiratory distress syndrome (ARDS), we measured the level of 7S collagen in the bronchoalveolar lavage (BAL) fluid of patients with ARDS and normal control subjects by using a radioimmunoassay method. Twelve of 14 patients with ARDS had evidence of 7S collagen in the BAL fluid, but no 7S collagen was detected in the BAL fluid of the controls. The mean 7S collagen concentration of the BAL fluid in patients with ARDS was 19.6 +/- 9.4 ng/ml. In patients with ARDS, the BAL levels of 7S collagen correlated strongly with neutrophil counts (r = 0.813; p less than 0.01) and with elastase-complex (r = 0.914; p less than 0.01). We conclude that 7S collagen may be an index of leukocyte-mediated lung injury in patients with ARDS, and detection of 7S collagen in BAL fluid is useful for evaluating the disruption of basement membrane.
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Affiliation(s)
- Y Kondoh
- Second Department of Internal Medicine, Faculty of Medicine, University of Nagoya, Japan
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Gommers D, van Daal GJ, Lachmann B. Oxygen uptake in the lungs under pathological conditions and its therapeutic efforts. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 1992; 317:47-54. [PMID: 1288159 DOI: 10.1007/978-1-4615-3428-0_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- D Gommers
- Dept. of Anesthesiology, Erasmus University, Rotterdam, The Netherlands
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Crowley JJ, Raffin TA. Tumor necrosis factor-induced protein phosphorylation in human neutrophils. Am J Respir Cell Mol Biol 1991; 5:284-91. [PMID: 1910814 DOI: 10.1165/ajrcmb/5.3.284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Protein phosphorylation is central to multiple regulatory processes in cells. Tumor necrosis factor (TNF), a cytokine synthesized by macrophages, effects polymorphonuclear leukocyte (neutrophil) chemotaxis, induces superoxide anion generation, and mediates neutrophil adhesion to endothelial cells. Although protein phosphorylation is almost certainly involved in many TNF-mediated neutrophil functions, little is known about TNF's impact on neutrophil protein phosphorylation. Therefore, we studied human recombinant TNF-alpha-induced protein phosphorylation in human neutrophils. Neutrophils were preincubated with 32PO(4)2- and treated with a variety of stimulatory agents. One- and two-dimensional polyacrylamide gel electrophoresis was used to analyze phosphorylated proteins. Phosphoaminoacids were identified by two-dimensional thin layer chromatography electrophoresis. The findings were as follows: (1) TNF induces the phosphorylation of two 16-kD proteins (pI = 5.9 and 6.1) by 5- to 6-fold, and a 57-kD protein (pI = 5.8) by 3- to 4-fold compared with untreated neutrophils; (2) these proteins are phosphorylated as early as 15 min after stimulation with TNF, and phosphorylation is induced by concentrations of TNF as low as 1 ng/ml (10 U/ml); (3) TNF induces the phosphorylation of proteins at either serine or threonine residues and not at tyrosine; (4) TNF-stimulated neutrophils show a unique pattern of protein phosphorylation when compared to neutrophils treated with formylmethionylleucylphenylalanine; (5) lipopolysaccharide does not induce protein phosphorylation in neutrophils; (6) a 16-kD protein is phosphorylated in response to TNF in neutrophils but not in mononuclear cells; and (7) protein kinase inhibitors appear to have no effect on TNF-induced protein phosphorylation. Thus, the mechanism of action of TNF on neutrophils may involve protein phosphorylation.
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Affiliation(s)
- J J Crowley
- Department of Medicine, Stanford University School of Medicine, California 94305-5236
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Bergh K, Olsen PO, Halgunset J, Iversen OJ. Complement activation and pulmonary dysfunction in experimental Escherichia coli septicaemia. Acta Anaesthesiol Scand 1991; 35:267-74. [PMID: 2038935 DOI: 10.1111/j.1399-6576.1991.tb03286.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Septicaemia was induced in anaesthetized and artificially ventilated rabbits. Three groups receiving different doses of Escherichia coli 055:B5 and a control group were studied. The animals were followed for 240 min after the start of the bacterial infusion. One animal in the high-dose and one in the medium-dose group died. Septic shock developed in the high-dose group. The infusion of E. coli led to a severe, sustained neutropenia and a dose-dependent thrombocytopenia. A severe arterial hypoxaemia developed during the infusion of bacteria in three of four animals, and in one of three animals in the high- and medium-dose groups, respectively. Both the levels of C5a in plasma and the accumulation of granulocytes in the lung tissue, as assessed by a morphometric method, were dependent on the dose of bacteria. A strong positive correlation was found between levels of C5a and endotoxin. The levels of both C5a and endotoxin correlated positively to the degree of accumulation of granulocytes in the lung tissue. The results from the present study suggest that the magnitude of bacteraemia and the degree of complement activation are probably important factors determining the course and the severity of septicaemia.
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Affiliation(s)
- K Bergh
- Department of Microbiology, Regional Hospital, Trondheim, Norway
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Carthew P, Edwards RE, Smith AG. Immunotoxic effects of hexachlorobenzene on the pathogenesis of systemic, pneumonic and hepatic virus infections in the mouse. Hum Exp Toxicol 1990; 9:403-11. [PMID: 2176797 DOI: 10.1177/096032719000900608] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A quantitative histopathological method has been developed for the evaluation of the effects of hexachlorobenzene (HCB) on the pathogenesis of three virus infections in the mouse. Hexachlorobenzene was selected because a substantial amount of immunotoxicological data already exists with which we could compare our results. To establish the validity of the method a systemic virus infection (mouse cytomegalovirus, MCMV), a pneumonia causing virus (pneumonia virus of mice, PVM) and a hepatitis virus (mouse hepatitis virus, MHV) were used. We have compared the existing data with the actual pathological effects of hexachlorobenzene on virus disease processes, to gain a more realistic idea of the value of the risk assessment to be derived from extrapolating the in-vitro data in particular, to the in-vivo situation. The results show that the data derived from previous studies on the immunotoxicity of HCB were accurate in predicting the exacerbation of the viral hepatitis, especially in immunodeficient athymic 'nude' mice. It is proposed that this histopathological technique could be a useful technique in the evaluation of host resistance changes following exposure to potentially immunotoxic compounds, but caution will have to be exercised in interpretation in relation to human disease.
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Affiliation(s)
- P Carthew
- MRC Toxicology Unit, MRC Laboratories, Carshalton, Surrey, UK
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Hangen DH, Segall GM, Harney EW, Stevens JH, McDougall IR, Raffin TA. Kinetics of leukocyte sequestration in the lungs of acutely septic primates: a study using 111In-labeled autologous leukocytes. J Surg Res 1990; 48:196-203. [PMID: 2314092 DOI: 10.1016/0022-4804(90)90213-l] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
To further clarify the role of leukocytes in the pathogenesis of ARDS, we studied the localization and kinetics of leukocyte migration using 111In-labeled autologous white cell scans (111In wbc scans) in four primates made acutely septic with infusions of Escherichia coli. Whole body images were obtained with a gamma camera and were acquired on computer every 15 min beginning immediately after the E. coli infusion. Simultaneous measurements of C5a and peripheral blood leukocyte count were also obtained. Within 5 min of initiating sepsis, three major events occurred: complement activation as measured by the production of C5a, a profound fall in peripheral leukocyte count, and a significant increase in the sequestration of leukocytes in the lungs. The pulmonary sequestration reached a peak at 15 min with a mean of 152% of baseline activity. This sequestration consisted of a population that was predominantly neutrophils. Damage to the pulmonary capillary endothelium was demonstrated by an increase in extravascular lung water. The results support a role for neutrophils and complement as mediators in the pathogenesis of ARDS.
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Affiliation(s)
- D H Hangen
- Department of Respiratory Medicine, Stanford University Medical Center, California 94305-5208
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Affiliation(s)
- G Sternbach
- Emergency Medicine Service, Stanford University Medical Center, California
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20
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Lilly CM, Sandhu JS, Ishizaka A, Harada H, Yonemaru M, Larrick JW, Shi TX, O'Hanley PT, Raffin TA. Pentoxifylline prevents tumor necrosis factor-induced lung injury. THE AMERICAN REVIEW OF RESPIRATORY DISEASE 1989; 139:1361-8. [PMID: 2524981 DOI: 10.1164/ajrccm/139.6.1361] [Citation(s) in RCA: 91] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Human tumor necrosis factor-alpha (TNF) is a monokine produced by mononuclear cells after many stimuli, including bacterial endotoxin. Full exploration of its antineoplastic effects has been limited by side effects. We have previously shown that the administration of TNF to guinea pigs is associated with a syndrome similar to gram-negative septic shock, which includes capillary permeability lung injury. In this study, we measured the effects of pentoxifylline (PTX) on parameters of TNF-induced lung injury including: lung wet-to-dry weight ratio, the ratio of lung-to-plasma 125I-labeled albumin (albumin index), bronchoalveolar lavage (BAL) and peripheral leukocyte counts, and serial measurements of mean arterial pressure (MAP). Four groups of animals were studied: a TNF group received 3.75 x 10(6) U/kg TNF; a PTX group received a 20-mg/kg bolus of PTX followed by an infusion of 6 mg/kg/h; the PTX-TNF group received both; and the final group was a saline control. ANOVA analysis revealed significant elevations of lung wet-to-dry ratio only in the TNF group (5.9 [5.6 to 6.3], p less than 0.001), expressed as the mean followed by 95% confidence intervals). Lung albumin index was elevated only in the TNF group (0.24 [0.19 to 0.29], p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- C M Lilly
- Department of Medicine, Stanford University Medical Center, California 94305-5204
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Mallick AA, Ishizaka A, Stephens KE, Hatherill JR, Tazelaar HD, Raffin TA. Multiple organ damage caused by tumor necrosis factor and prevented by prior neutrophil depletion. Chest 1989; 95:1114-20. [PMID: 2523293 DOI: 10.1378/chest.95.5.1114] [Citation(s) in RCA: 58] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The effect of TNF on nonpulmonary multiple organ damage (MOD) was studied. Since polymorphonuclear leukocytes (PMN) are thought to play an important role in septic or TNF-induced MOD, we investigated both neutrophil sufficient (PMN+) and neutropenic (PMN-) guinea pigs. Sepsis was induced by Escherichia coli administration (2 x 10(9)/kg) or recombinant human TNF (1.4 x 10(6) U/kg) was infused into PMN+ and PMN- guinea pigs. During necropsy, the PMN+/TNF and PMN+/E coli animals exhibited marked damage in the adrenal glands, kidneys and liver as evidenced by hemorrhage, congestion, and PMN sequestration on histopathologic examination. There was also increased tissue albumin accumulation in the adrenal glands, kidneys, spleen, heart, and liver as demonstrated by 125I-labeled albumin determinations. In contrast, the PMN-/TNF group did not reveal histopathologic damage in any organ system and there was no abnormal organ accumulation of 125I-albumin. However, in PMN-/E coli animals, marked histopathologic damage in the adrenal glands and liver was evident. Furthermore, there were marked accumulations of 125I-albumin in the adrenals, heart, kidneys, liver, and spleen. Moreover, the PMN-/E coli guinea pigs had a much greater accumulation (p less than 0.01) of 125I-albumin in the kidneys than any other group including the PMN+/E coli group. Thus, nonpulmonary MOD in guinea pigs is caused by TNF administration and can be prevented by PMN depletion. However, while E coli administration also caused marked nonpulmonary MOD in neutrophil sufficient guinea pigs, equivalent or greater damage was produced in neutropenic animals. This suggests that while TNF-induced MOD may be primarily mediated by PMN, E coli-induced MOD seems to be mediated by more than PMN.
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Affiliation(s)
- A A Mallick
- Department of Medicine, Stanford University Medical Center, CA 94305-5236
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Hangen DH, Stevens JH, Satoh PS, Hall EW, O'Hanley PT, Raffin TA. Complement levels in septic primates treated with anti-C5a antibodies. J Surg Res 1989; 46:195-9. [PMID: 2493531 DOI: 10.1016/0022-4804(89)90055-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
During gram-negative sepsis it is known that endotoxin activates complement by the alternate pathway. The complement anaphylatoxin C5a, a result of this activation, is thought to play a key role in attracting and activating neutrophils in the lungs, leading to the adult respiratory distress syndrome. Complement levels were measured in primates made septic by Escherichia coli infusions. Anti-human C5a antibodies were administered to study their effect on neutrophil-mediated lung injury. Control (I), septic (II) and septic + anti-C5a antibody (III) groups (n = 4) were studied. The antibody-treated group (III) demonstrated a significant attenuation of septic shock and pulmonary edema as has been previously reported. All complement profiles were corrected for varying hemoglobin concentrations. C3, C4, and C5 levels were measured by radial immunodiffusion and were depleted in both septic groups. Once the levels were depleted from the plasma, they did not recover. The depletion of C4 indicates that classical pathway activation also occurred. C3a, C4a, and C5a levels were measured by radioimmunoassay. Significantly increased peak levels were reached in the septic groups 15 min after initiation of the E. coli infusion. There were no significant differences in early peak C3a and C4a levels between groups II and III. However, the mean peak C5a level in group III (anti-C5a antibodies) was 42% lower than that in group II, and after this early peak, C5a levels were not elevated above control levels in group III. The antibody to human C5a was thus shown to be cross-reactive with primate C5a and was specific since C3a and C4a levels were not decreased in group III.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- D H Hangen
- Division of Respiratory Medicine, Stanford University Medical Center, California 94305
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24
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Bergh K, Iversen OJ. Measurement of complement activation in rabbit plasma or serum using monoclonal antibodies against C5a. Scand J Immunol 1989; 29:333-41. [PMID: 2470136 DOI: 10.1111/j.1365-3083.1989.tb01132.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Eight murine monoclonal antibodies (MoAb) raised against the major zymosan-induced chemotactic factor in rabbit serum were found to neutralize the chemotactic activity induced by lipopolysaccharides (LPS) and antigen-antibody complexes. A 15 kDa antigen was identified in plasma incubated with LPS by immunoblot analysis with MoAb. This is similar to the molecular weight of the major zymosan-induced chemotactic factor. Both the generation of this 15 kDa antigen and chemotactic activity were abrogated in a heat-inactivated plasma. A cross-reaction to human C5a was demonstrated for three MoAb (5H8B9, 4B1C11, and 2A5E3) in an indirect enzyme-linked immunosorbent assay (ELISA) of partially purified C5a and by the isolation of zymosan-induced chemotactic activity by affinity chromatography. MoAb 5H8B9 and 4B1C11 were able to neutralize the chemotactic activity in human zymosan-activated serum. MoAb 2A5E3 was able to bind 125I-labelled human C5a des Arg. We conclude that these MoAb are directed against rabbit C5a. MoAb 5B2C5 and 2B1A2, which are directed to different antigenic binding sites on C5a, may be applied in a sandwich ELISA for the detection and quantification of C5a des Arg in rabbit serum or plasma. The sandwich ELISA can be performed directly on serum or plasma samples without having to precipitate native C5. Complement activation is demonstrated by measuring the increased generation of C5a des Arg in rabbit plasma or serum activated with LPS, zymosan, antigen-antibody complexes, or cobra venom factor.
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Affiliation(s)
- K Bergh
- Department of Microbiology, University of Trondheim, Norway
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25
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Abstract
An attempt has been made to review the characteristics of fire and smoke and the epidemiology of smoke inhalation to identify some of the many variables which interact to control the severity of the injury. An experimental model appropriate to study the pulmonary injury of smoke victims who survive to enter the health care system is described. Experiments which define how smoke damages the lung are reviewed in an effort to explain why the smoke-damaged lung is vulnerable to additional stress and why those with an injured lung and a burn have such a high mortality rate.
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Affiliation(s)
- W R Clark
- Department of Surgery, State University of New York, Syracuse
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26
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Ishizaka A, Stephens KE, Tazelaar HD, Hall EW, O'Hanley P, Raffin TA. Pulmonary edema after Escherichia coli peritonitis correlates with thiobarbituric-acid-reactive materials in bronchoalveolar lavage fluid. THE AMERICAN REVIEW OF RESPIRATORY DISEASE 1988; 137:783-9. [PMID: 3281528 DOI: 10.1164/ajrccm/137.4.783] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
We developed a new model of acute lung injury caused by live Escherichia coli peritonitis in guinea pigs. Arterial blood gas determinations, arterial blood pressure, and white blood cell counts were monitored serially for 12 h after the injection of either 2 x 10(9) E. coli J96 or saline. Lung water, albumin concentration in bronchoalveolar lavage fluid (BALF) and in lung tissue, WBC counts in BALF, and thiobarbituric-acid-reactive materials (TBARM) in plasma, lung tissue, and BALF were examined. Increased TBARM might be associated with pulmonary injury and are produced either by the generation of lipoperoxides secondary to oxygen-free radicals or as metabolic byproducts of prostanoid metabolism. Lung tissue sections were studied by light microscopy. E. coli peritonitis, as compared with control animals, caused significant peripheral neutropenia, histopathologic evidence of lung inflammation, acidosis, and hypotension. The wet-to-dry lung ratio was increased in the peritonitis group when compared with that in the control group (p less than 0.01). Pulmonary edema in the peritonitis group was associated with significantly increased albumin concentrations in BALF and lung tissue. We report the new finding of increased TBARM concentrations in BALF after E. coli peritonitis (p less than 0.01 and p less than 0.05, respectively). In contrast, plasma TBARM concentrations were unchanged. The levels of TBARM in the BALF correlated significantly with both lung water (p less than 0.01) and lung tissue albumin concentration (p less than 0.01). The measurement of elevated TBARM in BALF may allow acute lung injury to be detected. We conclude that this model may be useful for further studies of acute lung injury caused by E. coli peritonitis.
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Affiliation(s)
- A Ishizaka
- Department of Medicine, Stanford University Medical Center, California 94305-5236
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Abstract
Adult Respiratory Distress Syndrome (ARDS) is a common diagnosis in today's intensive care units, representing a final common pathway of lung response to a variety of disease states. Mortality rates remain excessively high, despite comprehensive monitoring and intensive treatment. The incidence, etiology, clinical features, pathology and pathophysiology of ARDS are reviewed, with special emphasis on current research regarding potentially injurious mediators and possible etiopathogenetic mechanisms. Current therapy is summarized, and new therapeutic modalities are assessed. It is hoped that increased knowledge and awareness of the various aspects of ARDS will lead to further understanding and better clinical results in patients with this syndrome.
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Affiliation(s)
- C Putterman
- Intensive Care Unit, Rambam Medical Center, Haifa, Israel
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Wroblewski BM. Keeping up with orthopaedic epidemic. BMJ : BRITISH MEDICAL JOURNAL 1987; 295:923-4. [PMID: 3119104 PMCID: PMC1247957 DOI: 10.1136/bmj.295.6603.923-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Whitehouse A. Should sympathomimetics be available over the counter?:: Author's reply. BMJ : BRITISH MEDICAL JOURNAL 1987. [DOI: 10.1136/bmj.295.6603.924-a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Larrick JW, Wang J, Fendly BM, Chenoweth DE, Kunkel SL, Deinhart T. Characterization of murine monoclonal antibodies that recognize neutralizing epitopes on human C5a. Infect Immun 1987; 55:1867-72. [PMID: 2440808 PMCID: PMC260616 DOI: 10.1128/iai.55.8.1867-1872.1987] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
We generated a panel of 10 murine monoclonal antibodies (MAbs) that recognize human complement fragment C5a. These MAbs were characterized for their ability to immunoprecipitate 125I-labeled C5a, bind C5a in solid-phase enzyme immunoassay, and block 125I-labeled C5a binding to polymorphonuclear leukocytes. Four of these MAbs had affinity constants for C5a in the 1 X 10(9) to 3 X 10(9) M-1 range. These MAbs blocked C5a-induced neutrophil polarization and chemiluminescence. They blocked the ability of passively administered C5a to cause neutropenia in rabbits. These anti-C5a neutralizing MAbs may have potential therapeutic use in states of complement activation.
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Hangen DH, Bloom RJ, Stevens JH, O'Hanley P, Ranchod M, Collins J, Raffin TA. Adult respiratory distress syndrome. A live E coli septic primate model. THE AMERICAN JOURNAL OF PATHOLOGY 1987; 126:396-400. [PMID: 3548404 PMCID: PMC1899569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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el-Kassimi FA, Al-Mashhadani S, Abdullah AK, Akhtar J. Adult respiratory distress syndrome and disseminated intravascular coagulation complicating heat stroke. Chest 1986; 90:571-4. [PMID: 3757568 DOI: 10.1378/chest.90.4.571] [Citation(s) in RCA: 56] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Fifty two consecutive patients with heat stroke were examined for evidence of adult respiratory distress syndrome (ARDS) and disseminated intravascular coagulation (DIC). Twelve patients were found to have ARDS (incidence of 23 percent) of whom nine (75 percent) died. All of these 12 patients had DIC as compared to only one among the 40 patients without ARDS. Review of the evidence in literature linking ARDS and DIC and our own observations in this study lead to the conclusion that the coagulopathy may be an essential mediator of lung damage in heat stroke and is a reliable marker of its occurrence. This suggests the possibility that screening of heat stroke victims for DIC may identify patients at increased risk of developing overt ARDS and allow early institution of measures which may possibly improve survival.
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35
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Stevens JH, O'Hanley P, Shapiro JM, Mihm FG, Satoh PS, Collins JA, Raffin TA. Effects of anti-C5a antibodies on the adult respiratory distress syndrome in septic primates. J Clin Invest 1986; 77:1812-6. [PMID: 3711336 PMCID: PMC370538 DOI: 10.1172/jci112506] [Citation(s) in RCA: 180] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
In vitro and in vivo studies have suggested that human complement component C5a plays a key role in neutrophil injury in the adult respiratory distress syndrome (ARDS). First, using leukocyte aggregometry, we demonstrated that the addition of a recently developed rabbit anti-human polyclonal antibody to C5a des arg to endotoxin-activated plasma prevented leukocyte aggregation in vitro. We then administered the anti-C5a des arg antibody to septic primates (Macaca fascicularis). Three groups of primates, control, septic, and anti-C5a antibody treated septic, were studied (n = 4 in each group). A 30-min infusion of Escherichia coli (1 X 10(10)/kg) resulted in severe sepsis and ARDS. Primates were killed 4 h after completion of the E. coli infusion. Septic animals not treated with anti-C5a antibody had 75% mortality (3/4), decreased oxygenation, severe pulmonary edema, and profound hypotension. Septic primates treated with anti-C5a antibodies did not die and did not develop decreased oxygenation (P less than 0.05) or increased extravascular lung water (P less than 0.05). They also had a marked recovery in their mean arterial blood pressure (P less than 0.05). This study demonstrates that treatment with rabbit anti-human C5a des arg antibodies attenuates ARDS and some of the systemic manifestations of sepsis in nonhuman primates.
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