在严重脓毒症患者内源性蛋白C激活。

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在严重脓毒症患者内源性蛋白C激活。

暴击治疗地中海。2004年5月,32 (5):S214-8。

PubMed ID

15118520 (在PubMed

]

文摘

目的:评估如何内源性蛋白C激活可能会改变在疾病状态和讨论这些研究结果的含义在严重脓毒症的背景下。数据来源:回顾文献发表在PubMed和抽象的数据从2001年到现在。数据提取和合成:活化蛋白C (APC)补充已被证明在严重脓毒症患者死亡率显著降低,可能是由于它能够抑制凝血、炎症和细胞凋亡。体内,内源性APC在循环生成蛋白C激活thrombin-thrombomodulin复杂。蛋白C激活增强内皮细胞蛋白C受体。因此,thrombomodulin和内皮细胞蛋白C受体是endothelium-based的组件所需的“机械”有效地活化蛋白C在健康个体,APC的数量形成正比于凝血酶的水平。体外研究表明,thrombomodulin和内皮细胞蛋白C受体抑制炎性细胞因子,和这些受体的水平减少内皮的皮肤活检标本在儿童严重的脑膜炎球菌败血症。然而,切除血管内皮的研究只提供部分APC通路体内的照片。内源性血浆蛋白C水平的知识,凝血酶,APC可能有助于评估蛋白C通路的功能状态在体循环。到目前为止,很少有报告可用在严重脓毒症患者内源性APC级别,可能由于缺乏可用的化验,允许快速和准确的测量。 A unique feature of our study is that we have developed an APC assay that, for the first time, permits rapid and accurate measurements of plasma APC levels. Preliminary studies using this assay suggest that adult patients with severe sepsis vary markedly in their ability to generate APC endogenously. These results are intriguing because they suggest that, depending on individual defects in the protein C pathway, some patients have impaired protein C activation and might require APC therapy, whereas others may benefit from administration of protein C. Although the clinical efficacy of recombinant human APC (drotrecogin alfa [activated]) in severe sepsis has been reported in a phase III clinical trial, the efficacy of protein C in severe sepsis remains to be determined. CONCLUSIONS: Preliminary results suggest that adult patients with severe sepsis vary markedly in their ability to convert endogenous protein C to APC. Additional research is required to establish whether endogenous APC activation profiles are useful in the clinical management of patients with severe sepsis.

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药物靶点

药物	目标	类	生物	药理作用	行动
Drotrecogin阿尔法	内皮细胞蛋白C受体	蛋白质	人类	未知的	不可用	细节