Type III hypersensitivity reaction with immune complex deposition in 2 critically ill dogs administered human serum albumin

Powell, Cassandra; Thompson, Lisa C.; Murtaugh, Robert J.

doi:10.1111/vec.12085

Cited by 40 publications

(41 citation statements)

References 22 publications

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“…In humans, replacement with 100% FFP is also rare and it is reserved for specific conditions. 26,27 and Type III hypersensitivity reactions, 28,29 respectively. Neither hospital-acquired AKI nor progressive proteinuria could be detected in these dogs during hospitalization or follow-up.…”

Section: Anticoagulation and Citrate Toxicosismentioning

confidence: 99%

Membrane‐based therapeutic plasma exchange in dogs: Prescription, anticoagulation, and metabolic response

Francey

Schweighauser

2019

Veterinary Internal Medicne

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Background Therapeutic plasma exchange (TPE) is used increasingly in small animals to remove circulating large molecular products such as antibodies, pathogenic proteins, and protein‐bound toxins. Specific, efficient, and safe protocols need to be developed. Hypothesis/Objectives To describe the technique of membrane‐based TPE, the resulting physiological and metabolic changes, and to define an adequate regional citrate anticoagulation protocol. Animals Thirty‐four dogs treated with TPE (2011‐2017). Methods Retrospective review of all TPE treatments performed at the Vetsuisse Faculty, University of Bern, identified through a search of the institutional database for extracorporeal treatments. Results Sixty‐four treatments were performed, resulting in 1.0 plasma volume exchange (range, 0.4‐1.1). Replacement fluids included fresh frozen plasma (12%‐100% volume), colloids (0%‐52%), human albumin (0%‐41%), and saline (0%‐70%). Anticoagulation was performed with regional citrate (n = 24), systemic heparinization (n = 2), or combined (n = 38). Main relevant laboratory changes included a 24.7% decrease in total proteins (interquartile range, 16.7‐31.4; P < .001), 53% in fibrinogen (−30 to 63; P = .009), 36% in bilirubin (13‐43, P = .02), 9.0% in urea (0.7‐15.7; P < .001), and 4.5% in creatinine (−6.6 to 10.6; P = .006). Citrate accumulation was evidenced in all dogs, more pronounced in those with renal but not with hepatic impairment. Maximal tolerable citrate rates were estimated as 5.5 and 9.0 μmol/kg/min for treatments in dogs with and without renal impairment, respectively. Complications were observed in 22 treatments (34%) and were fatal in 2 dogs. Conclusions and Clinical Importance Therapeutic plasma exchange causes metabolic and biochemical alterations. Understanding these effects makes possible to anticipate most complications and to improve safety of the procedure.

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Section: Anticoagulation and Citrate Toxicosismentioning

confidence: 99%

Membrane‐based therapeutic plasma exchange in dogs: Prescription, anticoagulation, and metabolic response

Francey

Schweighauser

2019

Veterinary Internal Medicne

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“…The blood albumin level was positively related to the HSA dose on day 4. Interestingly, HSA levels in 12 groups were almost the same at the end of treatment, suggesting that supplemented HSA was catabolized completely with the time (Powell et al, 2013). …”

Section: Discussionmentioning

confidence: 99%

Weakening Impact of Excessive Human Serum Albumin (eHSA) on Cisplatin and Etoposide Anticancer Effect in C57BL/6 Mice with Tumor and in Human NSCLC A549 Cells

et al. 2016

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Excessive human serum albumin (eHSA) impact on anticancer effects is inconsistent. We explored the outcome of cisplatin (DDP)/etoposide (VP-16) plus eHSA in vivo and in vitro. C57BL/6 mice with tumor were used to compare the efficacy of DDP/VP-16 alone and DDP/VP-16+eHSA. Blood albumin was measured to confirm whether eHSA elevate its level. Western blotting assay were used to measure the expression of ERCC1/TOP2A in tumor tissues. Cell proliferation, mRNA, and protein expression of ERCC1/TOP2A were also assayed to compare two groups in A549 cells. Furthermore we evaluated eHSA impact on cell proliferation in RNAi targeting ERCC1/TOP2A in A549 cells, respectively. eHSA reduced the anticancer effect of DDP/VP-16 without altering albumin level, increased protein expression of ERCC1/TOP2A, respectively in mice. Similarly, eHSA increased mRNA and proteins expression of ERCC1/TOP2A in A549 cells. In RNAi A549 cells, however, eHSA no longer weakened but enhanced the anticancer effect of DDP, while no longer altered the effect of VP-16. Our findings suggested that eHSA weaken the anticancer effect of DDP/VP-16 via up-regulating ERCC1/TOP2A expression, respectively. Further molecular mechanism studies are warranted to investigate whether eHSA is not conducive to lung cancer chemotherapy.

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“…Therefore, a risk remains that endogenous or synthetic colloid administration could lead to the extravasation of these macromolecules into the interstitium and potentially worsen edema. There is limited availability of canine concentrated albumin solutions and human albumin may be harmful 181‐183 …”

Section: Therapeutic Interventions To Preserve or Restore The Endothementioning

confidence: 99%

“…There is limited availability of canine concentrated albumin solutions and human albumin may be harmful. [181][182][183] Fresh frozen plasma (FFP) has been studied extensively as a treatment for severe hemorrhage, but less research has been done in regards to its efficacy in repairing the EG. Animal hemorrhagic shock models have demonstrated that fluid resuscitation with FFP compared to crystalloids successfully restores the EG.…”

Section: Therapeutic Interventions To Preserve or Restore The Endothementioning

confidence: 99%

The endothelial glycocalyx: Structure and function in health and critical illness

Gaudette

Hughes

Boller

2020

J Vet Emergen Crit Care

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Objective To conduct a narrative review of the current literature in reference to the structure and function of the endothelial glycocalyx (EG) and its contribution to the pathophysiology of conditions relevant to the veterinary emergency and critical care clinician. Novel therapies for restoring or preserving the EG will also be discussed. Data Sources Online databases (PubMed, CAB abstracts, Scopus) were searched between January 1st 2017 and May 1st 2017 for English language articles without publication date restriction. Keywords included EG, endothelial surface layer, degradation, syndecan‐1, heparan sulfate, critical illness, sepsis, trauma, and therapeutics. Data Synthesis The EG is a complex and important structure located on the luminal surface of all blood vessels throughout the body. It plays an important role in normal vascular homeostasis including control of fluid exchange across the vascular barrier. Loss or degradation of the EG has an impact on inflammation, coagulation, and vascular permeability and tone. These changes are essential components in the pathophysiology of many conditions including sepsis and trauma. A substantial body of experimental animal and human clinical research over the last decade has demonstrated increased circulating concentrations of EG degradation products in these conditions. However, veterinary‐specific research into the EG and critical illness is currently lacking. The utility of EG degradation products as diagnostic and prognostic tools continues to be investigated and new therapies to preserve or improve EG structure and function are under development. Conclusions The recognition of the presence of the EG has changed our understanding of transvascular fluid flux and the pathophysiology of many conditions of critical illness. The EG is an exciting target for novel therapeutics to improve morbidity and mortality in conditions such as sepsis and trauma.

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Type III hypersensitivity reaction with immune complex deposition in 2 critically ill dogs administered human serum albumin

Cited by 40 publications

References 22 publications

Membrane‐based therapeutic plasma exchange in dogs: Prescription, anticoagulation, and metabolic response

Membrane‐based therapeutic plasma exchange in dogs: Prescription, anticoagulation, and metabolic response

Weakening Impact of Excessive Human Serum Albumin (eHSA) on Cisplatin and Etoposide Anticancer Effect in C57BL/6 Mice with Tumor and in Human NSCLC A549 Cells

The endothelial glycocalyx: Structure and function in health and critical illness

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