SYSTEMIC HOST DEFENCE FOLLOWING TRAUMA

创伤后的系统性宿主防御

• 批准号: 3270499
• 负责人: THOMAS G SABA
• 金额: $ 12.44万
• 依托单位: ALBANY MEDICAL COLLEGE
• 依托单位国家: 美国
• 财政年份: 1977
• 资助国家: 美国
• 起止时间: 1977-12-01 至 1986-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3270499
• 关键词: Kupffer's cell; affinity chromatography; alveolar macrophages; burns; computer data analysis; disease /disorder model; electron microscopy; fibrin; gel electrophoresis; human tissue; immunity; immunochemistry; immunofluorescence technique; immunologic assay /test; immunoregulation; macrophage; mathematical model; opsonin; perfusion; peritonitis; phagocytic dysfunction; phagocytosis; postoperative complications; pulmonary circulation obstruction; radiotracer; respiratory function; respiratory insufficiency /failure; reticuloendothelial system; shock; tissue /cell culture; trauma; vascular endothelium permeability; wound infection

The reticuloendothelial system (RES) is important in defense against trauma, burn, sepsis and intravascular coagulation. Bioassayable and immunoreactive opsonic deficiency and RES phagocytic failure exists following major surgery, trauma and burn especially with sepsis. We will evaluate the importance of opsonic deficiency and RES failure in the etiology of organ failure following trauma. Our hypothesis is that posttrauma pulmonary insufficiency may be due to lung microembolization due to the coexistence of RES depression and increased blood-borne particulates. Plasma fibronectin (opsonin) deficiency may also exaggerate the increased lung vascular permeability with sepsis. Opsonic protein has been isolated and an immunoassay developed. It is identical to cold-insoluble globulin (CIg) or plasma fibronectin which has a high affinity for denatured collagen, fibrin and injured tissue. "Plasma fibronectin" is antigenically related to the adhesive glycoprotein called "cell surface fibronectin" which may be important to cell-cell contact and endothelial cell adherence. Plasma cryoprecipitate which is rich in opsonic protein (CIg) can reverse opsonic deficiency in septic injured patients and may improve cardiopulmonary function. We will perform animal and patient studies which may lead to a new therapy for septic injured patients. We will investigate: 1) the influence of surgery, trauma and burn on RES defense against sepsis and intravascular coagulation; 2) the mechanism mediating opsonic depletion after trauma and sepsis as well as its restoration; 3) the influence of opsonic therapy on lung localization of blood-borne particulates as well as survival to post-operative and post-trauma sepsis; 4) the influence of opsonic deficiency as well as replacement therapy on lung vascular permeability during sepsis and/or intravascular coagulation; 5) the influence of cryoprecipitate therapy on pulmonary function in septic trauma patients. Immunoreactive opsonic fibronectin may have value as a non-invasive index of RES function and reversal of opsonic deficiency may have therapeutic value in septic burn and trauma patients.

网状内皮系统（RES）对于防御创伤很重要， 烧伤、败血症和血管内凝血。 可生物测定和免疫反应 大手术后存在调理缺陷和 RES 吞噬细胞衰竭， 创伤和烧伤，尤其是脓毒症。 我们将评估其重要性 调理素缺乏和 RES 衰竭在器官衰竭病因学中的作用 创伤。 我们的假设是外伤后肺功能不全可能是由于 RES 抑制并存导致肺微栓塞增加 血液传播的颗粒物。 血浆纤连蛋白（调理素）缺乏也可能 夸大脓毒症时肺血管通透性增加。 调理素 蛋白质已被分离并开发出免疫测定法。 它等同于 具有高亲和力的冷不溶性球蛋白 (CIg) 或血浆纤连蛋白 针对变性胶原蛋白、纤维蛋白和受伤组织。 “血浆纤连蛋白”是 与称为“细胞表面”的粘附糖蛋白具有抗原相关性 纤连蛋白”，这对于细胞间接触和内皮细胞可能很重要 坚持。 富含调理蛋白（CIg）的血浆冷沉淀物可以 逆转脓毒症损伤患者的调理缺陷并可能改善 心肺功能。 我们将进行动物和患者研究，这可能 为脓毒症患者带来一种新的治疗方法。 我们将调查：1） 手术、创伤和烧伤对RES防御败血症和烧伤的影响 血管内凝血； 2）调节调理声耗竭的机制 创伤和败血症及其恢复； 3）调理声的影响 对血源性颗粒物肺部定位以及生存的治疗 术后和创伤后败血症； 4）调理素缺乏的影响 以及脓毒症期间肺血管通透性的替代疗法和/或 血管内凝血； 5) 冷沉淀治疗的影响 脓毒症创伤患者的肺功能。 免疫反应调理剂 纤连蛋白可能具有作为 RES 功能和逆转的非侵入性指标的价值 调理素缺乏可能对化脓性烧伤和创伤具有治疗价值 患者。