Advertisement

Schock pp 241-252 | Cite as

Plasma fibronectin in abdominal sepsis and shock: Therapeutic and prognostic value

  • J. E. Doran
  • P. Lundsgaard-Hansen
Part of the Klinische Anästhesiologie und Intensivtherapie book series (KAI, volume 33)

Abstract

>In recent years, two assumptions have led to a sustained interest in the role played by plasma fibronectin (Fn) in health and disease. The first is that plasma Fn serves as a critical regulator of reticuloendothelial system (RES) function; the second, that subnormal Fn levels are of clinical significance. The structure and known activities of Fn provide the basis for these concepts (reviewed in, 4, 11). Plasma fibronectin has been shown to bind to products of intravascular coagulation, cell debris, denatured and native collagens, and to some bacteria. Its interactions with macrophages, monocytes, and neutrophils facilitate the clearance of Fn-bound targets by the cells of the RES. The clearance promoting capabilities of Fn are, however, limited to the “target particles” to which Fn can bind, and by physiologic factors that are as yet incompletely understood (11). Animal studies have demonstrated a parallelism between Fn levels, RES function, and ultimate mortality following blunt tissue trauma; however, such associations are not found in states of thrombin induced DIC, experimental endotoxemia, gram-negative bacteremia and burns (reviewed in 11). Fn levels in these experimental settings do not necessarily reflect RES function nor perturbations in the complement, coagulation, fibrinolytic, or kinin generating systems.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Annest, S. J., Scovill, W. A., Blumenstock, F. A., Stratton, H. H., Newell, J. C., Paloski, W. H., Saba, T. M., Powers, S. R.: Increased creatinine clearance following cryoprecipitate infusion in trauma and surgical patients with decreased renal function. J. Trauma 20, 726 (1980)PubMedCrossRefGoogle Scholar
  2. 2.
    Brodin, B.: Plasma fibronectin in septicaemia. A clinical study. Linkoeping University Medical Dissertations No. 169. Linkoeping, 1983Google Scholar
  3. 3.
    Brodin, B., Cedergren, B., Lieden, G., Malm, C., Strindberg, J., Vikrot, 0.: Prophylactic administration of cryoprecipi- tate to patients prone to develop fibronectin deficiency and septicemia. Abstracts of the 18th Congress of the International Society of Blood Transfusion. Munich July 22–27, 1984, p. 46, Basel: Karger 1984Google Scholar
  4. 4.
    Doran, J. E.: A critical assessment of fibronectin1s opsonic role for bacteria and microaggregates. Vox Sang. (Basel) 45, 337 (1983)Google Scholar
  5. 5.
    Doran, J. E., Callaway, B. D., Reese, A. C., Wynn, J. J., Mansberger Jr., A. R.: A competitive inhibition assay for gelatin binding fibronectin. Vox Sang. (Basel) 65, 243 (1983)Google Scholar
  6. 6.
    Doran, J. E., Mansberger, A. R., Reese, A. C.: Cold insoluble globulin-enhanced phagocytosis of gelatinized targets by macrophage monolayers: A model system. J. reticuloendothel. Soc. 21, 471 (1980)Google Scholar
  7. 7.
    Genestal, M., Sie, P., Hugot, B., Cathala, B., Boneu, B., Lareng, L.: Fibronectine plasmatique. Role dans l’infection sevère au reanimation. Presse Medicale 12, 1155 (1983)Google Scholar
  8. 8.
    Hesselvik, F., Brodin, B., Carlsson, C., Jorfeldt, L., Lieden, G., Cedergren, B.: Cryoprecipitate therapy in hyperdynamic septic shock - a controlled clinical study. Abstracts of the 18th Congress of the International Society of Blood Transfusion. Munich July 22–27, 1984, p. 46. Basel: Karger 1984Google Scholar
  9. 9.
    Lanser, M. E., Saba, T. M., Scovill, W. A.: Opsonic glycoprotein (plasma fibronectin) levels after burn injury. Relationship to extent of burn and development of sepsis. Ann. Surg. 192., 776 (1980)Google Scholar
  10. 10.
    Lundsgaard-HANSEN, P., Doran, J. E., Rubli, E., Papp, E., Morgenthaler, J.-J., Spâth, P.: Purified fibronectin ad-ministration to patients with severe abdominal infections. A controlled clinical trial. Ann. Surg. 202, 79 (1985)Google Scholar
  11. 11.
    Lundsgaard-Hansen, P., Doran, J. E., Rubli, E.: Plasma fibronectin: Relevance for anesthesiology and intensive care. Intensive Care Med. (In press)Google Scholar
  12. 12.
    Robbins, A. B., Doran, J. E., Reese, A. C., Mansberger Jr., A. R.: Clinical response to cold insoluble globulin replacement in a patient with sepsis and thermal injury. Amer. J. Surg. 142, 636 (1981)PubMedCrossRefGoogle Scholar
  13. 13.
    Rosner, B.: Fundamentals of biostatistics, p. 55–60. Boston: Duxbury Press 1982Google Scholar
  14. 14.
    Rubli, E., Bussard, S., Frei, E., Lundsgaard-Hansen, P., Pappova, E,: Plasma fibronectin and associated variables in surgical intensive care patients. Ann. Surg. 197, 310 (1983)PubMedCrossRefGoogle Scholar
  15. 15.
    Saba, T. M., Blumenstock, F. A., Scovill, W. A., Bernhard, H.: Cryoprecipitate reversal of opsonic alpha2 surface binding glycoprotein deficiency in septic surgical and trauma patients. Science 201, 622 (1978)PubMedCrossRefGoogle Scholar
  16. 16.
    Scovill, W. A., Saba, T. M., Blumenstock, F. A., Bernard, H., Powers, S. R.: Opsonic alpha2 surface binding glycoprotein therapy during sepsis. Ann. Surg. 188, 521 (1978)PubMedCrossRefGoogle Scholar
  17. 17.
    Scovill, W, A., Annest, S. J., Saba, T. M., Blumenstock, F. A., Newell, J, C., Stratton, H. H., Powers, S. R.: Cardiovascular hemodynamics after opsonic alpha-2-surface binding glycoprotein therapy in injured patients. Surgery 86, 284 (T979)Google Scholar
  18. 18.
    Smith-Erichsen, N., Aasen, A. 0.: Evaluation of severity and prognosis in early stages of septicemia by means of chromogenic peptide substrate assays. Europ. surg. Res. 16, Suppl. 2, T40 (1984)Google Scholar
  19. 19.
    Smith-Erichsen, N., Aasen, A. O., Gallimore, M. J., Amundsen, E.: Studies of components of the coagulation system in normal individuals and septic shock patients. Circulat Shock 9, 491 (1982)Google Scholar
  20. 20.
    Snyder, E. L., Barash, P. G., Mosher, D. F., Walter, S. D Plasma fibronectin level and clinical status in cardiac surgery patients. J. Lab. clin. Med. 102, 881 (1983)Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1987

Authors and Affiliations

  • J. E. Doran
  • P. Lundsgaard-Hansen

There are no affiliations available

Personalised recommendations