Therapeutic rationale for antithrombin III in sepsis
- 1 September 2000
- journal article
- review article
- Published by Wolters Kluwer Health in Critical Care Medicine
- Vol. 28 (9) , S34-S37
- https://doi.org/10.1097/00003246-200009001-00008
Abstract
To review the preclinical evidence that provides the therapeutic rationale for antithrombin as a novel treatment for human sepsis. A summary of published medical literature from MEDLINE search files and other reviews published about antithrombin use in sepsis. Antithrombin has a variety of anti-inflammatory properties in addition to its functions as an endogenous anticoagulant that appear to have an important therapeutic role in the prevention of microvascular dysfunction and multiple organ injury in sepsis. Appropriate timing and dosing of antithrombin III is critical to realize its full therapeutic potential as an anti-sepsis therapy. Antithrombin is a potent inhibitor of thrombin-mediated vascular injury in the microcirculation in severe sepsis. This endogenous anticoagulant is rapidly depleted in the early phases of sepsis as a result of decreased synthesis, increased destruction, and enhanced clearance by thrombin-antithrombin complex formation. The therapeutic efficacy of antithrombin in experimental sepsis is readily demonstrable in numerous animal systems. Appropriately defined patient populations with early onset severe sepsis and/or septic shock may benefit from antithrombin therapy if it is administered in adequate doses at the optimal time interval.Keywords
This publication has 25 references indexed in Scilit:
- Disseminated Intravascular CoagulationNew England Journal of Medicine, 1999
- Variation in plasminogen-activator-inhibitor-1 gene and risk of meningococcal septic shockThe Lancet, 1999
- 4G/5G promoter polymorphism in the plasminogen-activator-inhibitor-1 gene and outcome of meningococcal diseaseThe Lancet, 1999
- Antithrombin III in Animal Models of Sepsis and Organ FailureSeminars in Thrombosis and Hemostasis, 1998
- Derangements of Coagulation and Fibrinolysis in Critically III Patients with Sepsis and Septic ShockSeminars in Thrombosis and Hemostasis, 1998
- Pathogenesis of focal and random hepatocellular necrosis in endotoxemia: microscopic observation in vivoLiver International, 1996
- Sepsis/septic shockCritical Care Medicine, 1996
- Time Course of Hemostatic Abnormalities in Sepsis and its Relation to OutcomeChest, 1993
- Experimental endotoxemia in humans: analysis of cytokine release and coagulation, fibrinolytic, and complement pathwaysBlood, 1990
- THE NORMAL ANTITHROMBIN OF THE BLOOD AND ITS RELATION TO HEPARINAmerican Journal of Physiology-Legacy Content, 1938