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Recombinant activated protein C in sepsis: endothelium protection or endothelium therapy?

机译:败血症中的重组活化蛋白C:内皮保护还是内皮治疗?

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Endothelium dysfunction is one of the hallmarks of sepsis. Looney and Mattay, in the previous issue of Critical Care, highlight the role of activated protein C (APC) as a protective endothelial drug in septic situations. Nevertheless, the results of in vivo studies are less explicit and it remains uncertain whether these properties are relevant in human septic shock. Before considering recombinant APC (rAPC) as a therapeutic drug for the endothelium, we have to demonstrate its efficiency to protect or to reduce endothelium injury when infused a long time after the septic challenge. Nevertheless, if rAPC is efficient when infused in the early phase of septic challenge, we thus need to treat our patients earlier. At the least, genetically engineered variants have been designed with greater anti-apoptotic activity and reduced anticoagulant activity relative to wild-type APC. Further studies are needed to demonstrate the usefulness of these variants in septic shock therapy.
机译:内皮功能障碍是败血症的标志之一。 Looney和Mattay在上一期的《重症监护》中强调了活化蛋白C(APC)在脓毒症中作为保护性内皮药物的作用。然而,体内研究的结果尚不明确,这些属性是否与人类败血性休克有关尚不确定。在考虑将重组APC(rAPC)用作内皮治疗药物之前,我们必须证明在败血性感染后长时间输注它能保护或减少内皮损伤。但是,如果在败血性感染的早期输注rAPC是有效的,那么我们需要更早地治疗我们的患者。至少,已设计出相对于野生型APC具有更高的抗凋亡活性和降低的抗凝活性的基因工程变体。需要进一步的研究来证明这些变体在败血性休克治疗中的有用性。

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