chondroitin-sulfates and Shock--Septic

Previously it found that the bienzymatic conjugate superoxide dismutase-chondroitin sulfate, catalase (SOD-CHS-CAT) increased the survival rate of rats with endotoxic shock caused by the administration of lipopolysaccharide (LPS). This effect was observed both in preventive (before LPS) and therapeutic conjugate administration (after the administration of LPS). This study shows that the development of endotoxic shock is accompanied by increased levels of NO in the liver, lungs, kidneys, heart; administration of the SOD-CHS-CAT conjugate insignificantly influenced this parameter. At the same time, the changes in blood urea and creatinine suggest the protective effect of the conjugate on renal function, while diverse changes in biochemical parameters studied complicate the formation of the agreed conclusions on the state of other organs.. Ranee ustanovleno, chto bifermentnyĭ kon"iugat superoksiddismutaza-khondroitinsul'fat-katalaza (SOD-KhS-KAT) povyshal vyzhivaemost' krys s éndotoksicheskim shokom, vyzvannym vvedeniem lipopolisakharida (LPS). Étot éffekt otmechen kak pri vnutrivennom preventivnom (do LPS), tak i lechebnom (posle LPS) vvedenii kon"iugata v organizm. V dannoĭ rabote pokazano, chto pri razvitii éndotoksicheskogo shoka u krys v pecheni, legkikh, pochkakh, serdtse zhivotnykh otmechalsia povyshennyĭ uroven' soderzhaniia NO, kotoryĭ dostoverno ne izmenialsia posle vvedeniia kon"iugata SOD-KhS-KAT. V to zhe vremia, izmenenie pokazateleĭ soderzhaniia v krovi mocheviny i kreatinina svidetel'stvuet v pol'zu zashchitnogo deĭstviia kon"iugata na funktsiiu pochek, a raznoobrazie izmeneniĭ inykh biokhimicheskikh pokazateleĭ zatrudnialo formirovanie soglasovannykh zakliucheniĭ po sostoianiiu drugikh organov.

Topics: Animals; Antioxidants; Catalase; Chondroitin Sulfates; Enzyme Therapy; Lipopolysaccharides; Male; Nitric Oxide; Rats; Rats, Sprague-Dawley; Shock, Septic; Superoxide Dismutase

Glycosaminoglycans (GAGs) are negatively charged polysaccharides present, e.g., on the luminal face of the blood vessels as heparan sulphate (HS) and hyaluronic acid (HA), in the interstitium as HA, and in neutrofils and plasma as chondroitin sulphate (CS) and HA. Total plasma levels of GAG are increased in human septic shock, but the origin and pathophysiological implications are unclear. In order to determine the source of circulating GAG in sepsis, we compared plasma levels of HS, HA, CS and keratan sulphate (KS) in patients with septic shock and controls.. HS and KS were measured with enzyme-linked immunosorbent assay, and HA and CS disaccharides with liquid chromatography tandem mass spectrometry in plasma obtained from patients admitted to intensive care fulfilling criteria for septic shock as well as from matched control patients scheduled for neurosurgery.. Median levels of HS and HA were fourfold increased in septic shock and were higher in patients that did not survive 90 days (threefold and fivefold for HS and HA, respectively). Median CS levels were unaltered, while KS levels were slightly decreased in sepsis patients. HS and HA levels correlated with levels of interleukin-6 and interleukin-10. Except for HA, GAG levels did not correlate to liver or kidney sequential organ function score.. Median plasma level of HS and HA is increased in septic shock patients, are higher in patients that do not survive, and correlates with inflammatory activation and failing circulation. The increased levels could be due to vascular damage.

Topics: Adult; Aged; Aged, 80 and over; C-Reactive Protein; Chondroitin Sulfates; Disaccharides; Enzyme-Linked Immunosorbent Assay; Female; Glycosaminoglycans; Heparitin Sulfate; Humans; Hyaluronic Acid; Indicators and Reagents; Interleukin-10; Interleukin-6; Keratan Sulfate; Male; Middle Aged; Multiple Organ Failure; Peroxidase; Sepsis; Shock, Septic; Survival

Early clinical signs of heparin induced thrombocytopenia (HIT) are nonspecific and include a sudden drop in the number of platelets as well as formation of arterial and venous thromboses. Regional citrate anticoagulation (RCA) is increasingly used as a very effective modality to prevent filter clotting during renal replacement therapy (RRT). We report the first case where repeated premature filter clotting despite RCA indicated a manifestation of HIT.. A 71-year old woman admitted to the ICU for a compartment syndrome of the leg developed septic shock with acute kidney injury requiring continuous veno-venous hemodialysis (CVVHD). Because of unexpected and repeated premature filter clotting during CVVHD using RCA, HIT was suspected.. The diagnosis of HIT was confirmed by the presence of IgG antibodies against heparin and platelet factor (PF) 4 complexes and six points in the 4T score. Discontinuation of heparin administration and initiation of systemic anticoagulation with danaparoid sodium resulted in the normalization of platelet count and hemofilter lifetime.. RCA does not seem to be sufficient to prevent hemofilter clotting during HIT. Thus, in case of repeated premature filter clotting despite RCA, one should suspect HIT and prompt diagnostic workup as well as a switch to alternative anticoagulation.

Topics: Acute Kidney Injury; Aged; Anticoagulants; Chondroitin Sulfates; Citrates; Dermatan Sulfate; Equipment Failure; Female; Heparin; Heparitin Sulfate; Humans; Immunoglobulin G; Platelet Factor 4; Renal Dialysis; Shock, Septic; Thrombocytopenia; Thrombosis

Topics: Adult; Burns; Chondroitin Sulfates; Collagen; Fatal Outcome; Female; Humans; Methicillin-Resistant Staphylococcus aureus; Shock, Septic; Staphylococcal Infections; Wound Infection