The Lysosomal Protease — Myocardial Depressant Factor System in Circulatory Shock

  • Allan M. Lefer
  • Thomas M. Glenn
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 33)


Circulatory shock is characterized by severe perturbations in the homeostatic regulation of cardiovascular function leading to conditions which are incompatible with life. The nature of these perturbations is not clearly understood, nor are the origins of the positive feedback loops generated by these disturbances. Despite the obvious gaps in our knowledge, certain findings have been uncovered in recent years which, in the light of new information, point to a final common pathway in the pathogenesis of circulatory shock. These findings are:
  1. 1.

    a marked reduction in blood flow to the splanchnic viscera very early in circulatory shock of varying etiologies (1)

  2. 2.

    a marked alteration in lysosomal membranes with the attendant release of lysosomal hydrolases into the plasma during many forms of shock (2)

  3. 3.

    a profound impairment of myocardial performance late in circulatory shock (3,4)



Positive Feedback Loop Lysosomal Enzyme Lysosomal Membrane Negative Inotropic Effect Toxic Factor 
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Copyright information

© Plenum Press, New York 1973

Authors and Affiliations

  • Allan M. Lefer
    • 1
  • Thomas M. Glenn
    • 1
  1. 1.Department of Physiology, School of MedicineUniversity of VirginiaCharlottesvilleUSA

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