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Báo cáo khoa học: "A Clinical review: Molecular mechanisms underlying the role of antithrombin in sepsis"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: A Clinical review: Molecular mechanisms underlying the role of antithrombin in sepsis. | Available online http ccforum.eom content 10 1 209 Review Clinical review Molecular mechanisms underlying the role of antithrombin in sepsis Christian J Wiedermann 2nd Divison of Internal Medicine Department of Medicine Central Hospital of Bolzano Bolzano Italy Corresponding author Christian J Wiedermann christian.wiedermann@asbz.it Published 13 February 2006 This article is online at http ccforum.com content 10 1 209 2006 BioMed Central Ltd Critical Care 2006 10 209 doi 10.1186 cc4822 Abstract In disseminated intravascular coagulation DIC there is extensive crosstalk between activation of inflammation and coagulation. Endogenous anticoagulatory pathways are downregulated by inflammation thus decreasing the natural anti-inflammatory mechanisms that these pathways possess. Supportive strategies aimed at inhibiting activation of coagulation and inflammation may theoretically be justified and have been found to be beneficial in experimental and initial clinical studies. This review assembles the available experimental and clinical data on biological mechanisms of antithrombin in inflammatory coagulation activation. Preclinical research has demonstrated partial interference of heparin -administered even at low doses - with the therapeutic effects of antithrombin and has confirmed - at the level of cellular mechanisms - a regulatory role for antithrombin in DIC. Against this biological background re-analyses of data from randomized controlled trials of antithrombin in sepsis suggest that antithrombin has the potential to be developed further as a therapeutic agent in the treatment of DIC. Even though there is a lack of studies employing satisfactory methodology the results of investigations conducted thus far into the mechanisms of action of antithrombin allow one to infer that there is biological plausibility in the value of this agent. Final assessment of the drug s effectiveness however must await the availability of positive prospective randomized and .