The Occurrence and Significance of Fibrin/Fibrinogen Degradation Products (FDP) in Acute Infections

Skånsberg, Per; Cronberg, S; Nilsson, Inga Marie

doi:10.3109/inf.1974.6.issue-2.16

Cited by 7 publications

(3 citation statements)

References 18 publications

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“…Similarly, activation of plasmin and thus of fibrinolysis is responsible for the elevated plasma levels of fibrin(ogen) split products (FSP, cf. Table 3) (Skansberg et al 1974). In this case, however, a tendency to normalization was clearly visible towards the end of the observation period.…”

Section: Clotting and Fibrinolysismentioning

confidence: 69%

Proteinase Inhibitors in Severe Inflammatory Processes (Septic Shock and Experimental Endotoxaemia): Biochemical, Pathophysiological and Therapeutic Aspects

Fritz

1980

Ciba Foundation Symposium 75 ‐ Protein Degradation in Health and Disease

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Plasma levels of antithrombin III, «2-macroglobulin and inter-atrypsin inhibitor, as well as those of various clotting, complement and other plasma factors, were significantly decreased in 18 patients suffering from hyperdynamic septic shock. A similar statistically significant reduction of the concentrations of several plasma factors (prothrombin and antithrombin III, plasminogen and «2-plasmin inhibitor, complement factor C3 and clotting factor XIII) was observed in experimental endotoxaemia. In this model the reduction in the plasma levels of these factors was considerably diminished by the intravenous injection of a granulocytic elastase-cathepsin G inhibitor of lower molecular weight from soybeans. The results of both studies indicate that consumption of plasma factors in the course of Gram-negative sepsis proceeds not only via the classical routes (by activation of the clotting, fibrinolytic and complementcascades by system-specific proteinases such as thrombokinase or the plasminogen activator) but also to an appreciable degree by unspecific degradation of plasma factors by neutral proteinases such as elastase and cathepsin G. The endotoxininduced release of both sorts of proteinases, the system-specific ones and the unspecific lysosomal proteinases from leucocytes and other cells, is likely to be mainly responsible for the consumption of antithrombin III and c*2-macroglobulin via complex formation (followed by elimination of the complexes) and the increased turnover of the inter-a-trypsin inhibitor as observed in the clinical study.The therapeutic use of an exogenous elastase-cathepsin G inhibitor in the experimental model was stimulated by the observation that human mucous secretions contain an acid-stable inhibitor of the neutral granulocytic proteinases, called HUSI-I or antileucoproteinase. This inhibitor protects mucous membranes 351

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Section: Clotting and Fibrinolysismentioning

confidence: 69%

Proteinase Inhibitors in Severe Inflammatory Processes (Septic Shock and Experimental Endotoxaemia): Biochemical, Pathophysiological and Therapeutic Aspects

Fritz

1980

Ciba Foundation Symposium 75 ‐ Protein Degradation in Health and Disease

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“…In the United Kingdon and other developed countries, the most significant impact of sepsis is within the ICU [22]. The care of such patients is financially burdensome and tests that could improve treatment delivery and outcomes, including shorter ICU stay would likely be clinically cost-effective.…”

Section: Discussionmentioning

confidence: 99%

The clinical utility of fibrin-related biomarkers in sepsis

Toh

Ken‐Dror²,

Downey³

et al. 2013

Blood Coagulation &Amp; Fibrinolysis

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Sepsis is associated with systemic inflammatory responses and induction of intravascular fibrin formation. Our aim is to investigate whether three fibrin-related markers (FRM) reflect the extent of coagulation activation in vivo and evaluate their clinical usefulness in identifying as well as monitoring patients with sepsis. Fibrin-degradation products (FDP), D-dimer and soluble fibrin monomer assays were measured on plasma samples from patients in the ICU with sepsis (n = 37), systemic inflammatory response syndrome (SIRS) (n = 35) and healthy individuals (n = 15). The levels were correlated with each other and also with fibrinogen, prothrombin time, platelets and antithrombin III. Clinical correlation was also performed for the diagnosis of sepsis and longitudinal monitoring for survival or death.There was strong correlation between the three FRM (r = 0.38-0.93, P < 0.0001) with only fibrin monomer correlating significantly with prothrombin time, fibrinogen and platelet levels. Clinically, all three FRM could discriminate between patients with sepsis, SIRS and healthy individuals with FDP, and D-dimer showing statistical significance (P < 0.05). No FRM predicted outcome from a single measurement but FDP was significantly able to predict patient survival from serial samples [mean FDP (μg/ml) from 35.36 to 21.37 (first to third ICU-day), P < 0.05]. Fibrin monomer appears the most sensitive indicator of coagulation activation, whereas D-dimer and FDP levels can significantly differentiate ICU patients with sepsis from those without. In addition, FDP would be preferable for monitoring with its statistically significant time-dependent prediction of survival or death from sepsis.

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“…This first split product of fibrinogen during c10tting is suggested to be highly characteristic for generated thrombin activity [23]. Similarly, activation of plasminogen and thus of fibrinolysis is responsible for the elevaled plasma levels oj jibrin(ogen) splil producis [33].…”

Section: Discussionmentioning

confidence: 99%

Disturbances of selected plasma proteins in hyperdynamic septic shock

et al. 1982

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Abstract. This study was performed on patients (n = 18) suffering from strictly defined hyperdynamic septic shock. Plasma faclors (C-reactive protein, acid al-glycoprotein, fibri nogen, fibrinopeptide A, fibrinogen-fibrin split products, factor XIII, antithrombin III, complement factors C3 and C4, interet-trypsin-inhibitor and CtrmacrogJobulin) measured during hyperdynamic septic shock were highly abnormal. The actjvation and consumption of dotting, fibrinolytic and complement factors due to systemspeeific proteinases (such as thrombokinase or plasminogen aetivators) seemed to be intensified by the nonspecific proteolytic activity of granuloeytic proteinases probably released by the action of endotoxins. Possible therapeutie measures {o maintain the endogeneous defenee meehanism against enhaneed proteolysis during septic shoek are diseussed.

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The Occurrence and Significance of Fibrin/Fibrinogen Degradation Products (FDP) in Acute Infections

Cited by 7 publications

References 18 publications

Proteinase Inhibitors in Severe Inflammatory Processes (Septic Shock and Experimental Endotoxaemia): Biochemical, Pathophysiological and Therapeutic Aspects

Proteinase Inhibitors in Severe Inflammatory Processes (Septic Shock and Experimental Endotoxaemia): Biochemical, Pathophysiological and Therapeutic Aspects

The clinical utility of fibrin-related biomarkers in sepsis

Disturbances of selected plasma proteins in hyperdynamic septic shock

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