Antithrombin inhibits bronchoalveolar activation of coagulation and limits lung injury during Streptococcus pneumoniae pneumonia in rats

Goda Choi, Jorrit-Jan H. Hofstra, Joris J. T. H. Roelofs, Anita W. Rijneveld, Paul Bresser, Jaring S. van der Zee, Sandrine Florquin, Tom van der Poll, Marcel Levi, Marcus J. Schultz

OnderzoeksoutputAcademicpeer review

53 Citaten (Scopus)

Samenvatting

OBJECTIVE: Alveolar fibrin deposition is a hallmark of pneumonia. It has been proposed that natural inhibitors of coagulation, including activated protein C, antithrombin, and tissue factor pathway inhibitor, exert lung-protective effects via anticoagulant and possibly anti-inflammatory pathways. We investigated the role of these natural anticoagulants in Streptococcus pneumoniae pneumonia.

DESIGN: A controlled in vivo laboratory study.

SETTING: Research laboratory of a university hospital.

SUBJECTS: Total of 98 male Sprague-Dawley rats.

INTERVENTIONS: Rats were challenged intratracheally with S. pneumoniae (serotype 3, 10(6) colony forming units), inducing pneumonia. Rats were randomized to intravenous treatment with normal saline, activated protein C, antithrombin, tissue factor pathway inhibitor, heparin, or tissue-type plasminogen activator.

MEASUREMENTS AND MAIN RESULTS: Rats infected with S. pneumoniae had increased thrombin-antithrombin complexes in bronchoalveolar lavage fluid, with decreased levels of antithrombin activity and fibrin degradation products. Administration of activated protein C, antithrombin, and tissue factor pathway inhibitor significantly limited these procoagulant changes. Furthermore, antithrombin treatment resulted in less bacterial outgrowth of S. pneumoniae and less histopathologic damage in lungs.

CONCLUSIONS: Anticoagulant treatment attenuates pulmonary coagulopathy during S. pneumoniae pneumonia. Antithrombin seems to exert significant lung-protective effects in pneumococcal pneumonia in rats.

Originele taal-2English
Pagina's (van-tot)204-210
Aantal pagina's7
TijdschriftCritical Care Medicine
Volume36
Nummer van het tijdschrift1
DOI's
StatusPublished - jan-2008
Extern gepubliceerdJa

Citeer dit