Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Plasma fibronectin was measured in patients with breast cancer, colon cancer, and acute leukemia. In the patients with solid tumors, mean levels were significantly elevated above the mean level of age- and sex-matched normals whether the disease was thought to be metastatic or not (P less than 0.001). It did not make a difference whether the determinations were done prior to or during chemotherapy. Fibronectin was measured serially in eight hospitalized patients with leukemia during intensive induction chemotherapy. Normal concentrations were found prior to therapy. However, fibronectin concentration fell on the day following chemotherapy in nine of 12 episodes (P less than 0.05), and during sepsis in 13 of 13 episodes (P less than 0.001). Thus, the concentration was influenced by at least two factors: recent chemotherapy and sepsis. Because fibronectin concentration is sensitive to clinical events other than the status of the malignancy, it seems unsuitable as a tumor marker, at least as a single isolated measurement.
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PMID:Fibronectin concentration in plasma of patients with breast cancer, colon cancer, and acute leukemia. 657 2

Sepsis, abscess formation or development of purulent exudates in closed cavities expresses insufficient host defense against pyogenic infections. An attempt is made to analyse the reasons for diminished host resistance and/or increased virulence of the invading microbes. While the role of cellular defense mechanisms is not considered, a number of humoral components, such as lysozymes glycolipids, lactoperoxidase, fibronectin, esterases and haptoglobin, participate in efficient defense. Special emphasis is placed on serum complement, both with regard to its unspecific but nevertheless efficient alternative pathway, and with respect to its phylogenetically much more recent classical pathway. Recognition of bacteria by either mechanism of complement activation leads to C3b deposition on the microbial surface for efficient opsonization, while the juxtaposition of at least two molecules of antibodies contained in the immunoglobulin fraction of plasma safely leads to complement activation via the classical pathway. Therefore, specific recognition of bacteria by immunoglobulin-antibodies remains the core of anamnestic antimicrobial defense, the more so since some antibodies may also confer on the bacterial surface the capacity to activate the alternative pathway. The recent description of monoclonal antibody directed at bacteria relevant in sepsis opens perspectives in the near future when such components will eventually be used for therapeutic purposes, along with antibodies also directed towards the pathogenetic bacterial products endo- and exotoxin.
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PMID:[The role of complement and specific antibodies in the development and defense mechanism of sepsis and septic shock]. 662 30

In a study of 27 thermally burned patients (mean TBSA, 58%; range, 32-96%) serum fibronectin levels were decreased with parallel decreased oxygen consumption of stimulated peripheral blood phagocytes and decreased EGTA-blocked burn serum opsonizing activity which correlated with serum fibronectin changes postburn. Normal and burn sera fibronectin content also correlated with the opsonizing times for zymosan and Staphylococcus aureus but not for Enterobacteriaceae. Although in vivo 14 cases showed circulating fibronectin 140 micrograms/ml or lower and a marked decrease in Staphylococcus aureus opsonization, only two patients from this group revealed positive Staphylococcus aureus blood cultures and serum fibronectin levels were higher in patients with Staphylococcus aureus sepsis than in patients with Enterobacteriaceae sepsis. Supplementary experiments on leukocyte oxidative response after zymosan stimulation in normal, fibronectin-depleted, and fibronectin-reconstituted serum demonstrated that the lag period of oxygen burst is a fibronectin-dependent reaction.
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PMID:Effect of circulating fibronectin on stimulation of leukocyte oxygen consumption and serum opsonizing function in burned patients. 663 11

Fibronectin is a large opsonic glycoprotein which promotes reticuloendothelial system clearance of bacteria, immune complexes, collagenous debris, and damaged platelets. The concentration of plasma fibronectin is decreased in the newborn infant; however, the role of fibronectin in the onset and course of neonatal sepsis is unknown. Serial plasma fibronectin levels were determined in 19 neonates with documented bacterial sepsis. Plasma fibronectin concentrations decreased significantly (P less than .001) in all study infants concurrent with the development of septicemia. Recovery of plasma fibronectin to normal levels occurred by day 5 in premature neonates and by days 7 to 10 in term neonates. Fibronectin deficiency and resultant reticuloendothelial system impairment may decrease the ability of newborn infants to resist or clear bacterial infections. An acute reduction in the concentration of plasma fibronectin may be a valuable marker for neonatal sepsis.
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PMID:Decreased plasma fibronectin in neonatal sepsis. 664 31

Various parameters of fibrinolysis inhibition and the plasma concentration of fibronectin (alpha 2-surface binding glycoprotein, cold insoluble globulin) were measured in patients at risk of developing acute progressive respiratory sufficiency following trauma or sepsis - the delayed microembolism syndrome (DMS). Most parameters measuring fibrinolysis inhibition were significantly higher in the five patients with DMS than in five patients who did not develop the syndrome. Thus, the primary fibrinolysis inhibitor (alpha 2-antiplasmin) was enhanced and the alpha-form of this inhibitor, with affinity to plasminogen, showed the greatest increment and might be of major importance for the delayed elimination of fibrin from the lungs occurring in these patients. The fibronectin concentrations were not lower in patients with DMS than in those who did not develop the syndrome.
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PMID:Fibrinolysis inhibition and fibronectin in the blood in patients with the delayed microembolism syndrome. 664 94

A survey is given on the clinical relevance of microaggregates in stored blood. Initially the pathophysiology of aggregation led by electrostatic and humoral changes on the surface and membrane of the platelets is presented, and the well known pathomechanisms of embolization as well as the functional pulmonary impact of these emboli are discussed. The ever increasing importance of humoral factors is stressed, the mechanic obstruction of pulmonary capillaries by microaggregates having not that clinical importance as the general opinion in earlier days has been. New therapeutic aspects therefore are mentioned: The blockade of aggregation and the release syndrome by adding aspirin, aprotinin or prostaglandin E 1 to the stored blood, pharmacologically influencing the metabolism of arachidonic acid by inhibiting negative effects of prostaglandins (injecting ibuprofen as inhibitor of thromboxane-synthesis) and stimulating positive prostaglandin effects (infusion of prostacyclin), and finally the application of fibronectin (cryoprecipitates) for increasing the RES-function thus also enhancing the clearance of microaggregates, fibrinogen/fibrin complexes and intestinal serotonin. The latter way only, however, is also clinically feasable. The purely mechanical microfiltration should therefore still be used (3 pints of blood at least, pulmonary damage by trauma, shock or sepsis) and the methods of giving aggregate-poor red cell preparations (buffy coat free or saline washed) should be remembered. For the future one could speculate that more or less complete humoral block might be used in conjunction with a "midi-filtration" (Eckert: 40-100 mu diameter standard blood filter).
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PMID:[Clinical relevance of microaggregates in stored blood]. 665 92

The nonspecific host defense system of 66 patients with thermal injuries was studied prospectively. Our goal was to correlate the magnitude of injury with changes in host defenses and to determine if the responses of patients with and without sepsis were different. Eighteen patients experienced one or more septic episodes. Synchronous serial measurements of circulating fibronectin levels, neutrophil locomotive activity and phagocytosis, and intracellular killing in all patients showed that multiple components of the nonspecific host defense system were impaired after thermal injury. The depression of random migration and chemotaxis and the magnitude of the initial depression in serum fibronectin levels were related to the severity of injury but did not predict sepsis. Only a decrease in neutrophil bactericidal activity or a secondary depression in the serum fibronectin level was associated with the onset of sepsis.
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PMID:Sequential prospective analysis of the nonspecific host defense system after thermal injury. 668 77

Plasma fibronectin is a large molecular weight glycoprotein which may have both opsonic and structural adhesive roles. Fibronectin deficiency has been documented in patients especially early after trauma or burn as well as during sepsis following injury. In this study, the disappearance of fibronectin from the blood was studied in rats utilizing plasma fibronectin metabolically labelled with 75Se-selenomethionine. After injection of 75Se-selenomethionine, the maximum specific activity of endogenously labelled plasma fibronectin, the observed at 4 hours. Thereafter, it declined in a non-monoexponential fashion in association with depletion of the precursor. Labelled 75Se fibronectin was purified from donor rat plasma by gelatin-sepharose affinity chromatography. It retained its electrophoretic mobility, gelatin adherence, and opsonic activity similar to that of unlabelled plasma fibronectin. Following intravenous injection of 75Se plasma fibronectin, its disappearance from plasma manifested two phases. The first was an initial fast disappearance of a small amount of fibronectin, reflecting distribution between plasma and interstitial compartments. The second was a slower disappearance phase with a half-time (T 1/2) of at least 15 hours. Infusion of gelatin-coated particles, which are rapidly cleared by RE cells in the liver and spleen, enhanced the disappearance of 75Se fibronectin from the plasma. These data suggest that the normal rate of fibronectin disappearance from the vascular space is quite fast. Utilization of this experimental approach may provide valuable data on fibronectin kinetics as influenced by trauma and burn.
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PMID:Clearance from the vascular compartment of endogenously labelled plasma fibronectin. 669 47

Plasma fibronectin levels in 66 medical ICU (MICU) patients were measured daily. Mean values of initial levels were significantly higher in survivors (266 +/- 14 mg/L) than nonsurvivors (179 +/- 13 mg/L; p less than .0003). There was extensive overlap between survivors and nonsurvivors. The clinical categories of sepsis, disseminated intravascular coagulation (DIC), adult respiratory distress syndrome (ARDS), and hepatic failure with GI bleeding were associated with low fibronectin levels. Within all diagnostic categories the mean initial fibronectin level of the survivors was higher than that of nonsurvivors. This difference was significant only in the septic group (p less than .02). Patients with minimum fibronectin levels less than 195 mg/L had a 65% mortality rate; patients with minimum levels greater than or equal to 195 mg/L had a 17% mortality rate. Fibronectin, via its role in reticuloendothelial system (RES) function, may have a pathophysiologic role in a variety of medical illnesses.
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PMID:Plasma fibronectin in medical ICU patients. 672 31

The plasma fibronectin level was determined by immunoelectrophoresis in patients under intensive care. The decrease in plasma fibronectin concentration was most pronounced in patients with sepsis and DIC. Survival of these patients was related to the extent of decrease of the plasma fibronectin concentration. Burn injury and the associated surgical treatment were followed by a decrease in fibronectin concentration which then normalized in 24-48 h after the burn injury. It is concluded that serial determinations of plasma fibronectin are essential for studying the relation of a low plasma fibronectin with the clinical condition.
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PMID:Plasma fibronectin concentration in patients admitted to intensive care unit. 672 57


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