Abstract
Critically ill patients are commonly associated with systemic inflammatory response syndrome (SIRS) and are at a greater risk of developing acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Under these conditions, large amounts of various cytokines are produced, which either directly or indirectly induce tissue injury and finally organ dysfunctions, through the activation of neutrophils and as a result of release of cytotoxic molecules, especially neutrophil elastase (NE). In the present study, we determined plasma neutrophil elastase-alpha-1 antitrypsin complex (NE-AT) and elastase digests of cross-linked fibrin (e-XDP) in critically ill patients to elucidate the significance of NE in the initiation and progression of ALI and ARDS in the presence or absence of SIRS. We found significantly increased levels of plasma NE-AT in the patients with ARDS, especially when the definition of SIRS was met. Among ALI/ARDS groups, plasma NE-AT, but not e-XDP, correlated significantly with the decrease in PaO2/FIO2 ratio and the duration of ALI/ARDS. Furthermore, NE-AT, but not e-XDP, significantly increased in subgroups whose PaO2/FIO2 ratio decreased by more than 20%. Such correlations and differences between the subgroups were not observed in the non-ALI patients. From these results, we speculate that NE-AT, but not e-XDP, may be predictive of progressive lung injury in the early stage of ALI and ARDS.
| Original language | English |
|---|---|
| Pages (from-to) | 333-338 |
| Number of pages | 6 |
| Journal | Biomedicine and Pharmacotherapy |
| Volume | 62 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 2008 Jun |
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Keywords
- ALI
- ARDS
- SIRS
ASJC Scopus subject areas
- Pharmacology
Cite this
Neutrophil elastase and systemic inflammatory response syndrome in the initiation and development of acute lung injury among critically ill patients. / Fujishima, Seitaro; Morisaki, Hiroshi; Ishizaka, Akitoshi; Kotake, Yoshifumi; Miyaki, Masaru; Yoh, Kikuo; Sekine, Kazuhiko; Sasaki, Junichi; Tasaka, Sadatomo; Hasegawa, Naoki; Kawai, Yohko; Takeda, Junzo; Aikawa, Naoki.
In: Biomedicine and Pharmacotherapy, Vol. 62, No. 5, 06.2008, p. 333-338.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Neutrophil elastase and systemic inflammatory response syndrome in the initiation and development of acute lung injury among critically ill patients
AU - Fujishima, Seitaro
AU - Morisaki, Hiroshi
AU - Ishizaka, Akitoshi
AU - Kotake, Yoshifumi
AU - Miyaki, Masaru
AU - Yoh, Kikuo
AU - Sekine, Kazuhiko
AU - Sasaki, Junichi
AU - Tasaka, Sadatomo
AU - Hasegawa, Naoki
AU - Kawai, Yohko
AU - Takeda, Junzo
AU - Aikawa, Naoki
PY - 2008/6
Y1 - 2008/6
N2 - Critically ill patients are commonly associated with systemic inflammatory response syndrome (SIRS) and are at a greater risk of developing acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Under these conditions, large amounts of various cytokines are produced, which either directly or indirectly induce tissue injury and finally organ dysfunctions, through the activation of neutrophils and as a result of release of cytotoxic molecules, especially neutrophil elastase (NE). In the present study, we determined plasma neutrophil elastase-alpha-1 antitrypsin complex (NE-AT) and elastase digests of cross-linked fibrin (e-XDP) in critically ill patients to elucidate the significance of NE in the initiation and progression of ALI and ARDS in the presence or absence of SIRS. We found significantly increased levels of plasma NE-AT in the patients with ARDS, especially when the definition of SIRS was met. Among ALI/ARDS groups, plasma NE-AT, but not e-XDP, correlated significantly with the decrease in PaO2/FIO2 ratio and the duration of ALI/ARDS. Furthermore, NE-AT, but not e-XDP, significantly increased in subgroups whose PaO2/FIO2 ratio decreased by more than 20%. Such correlations and differences between the subgroups were not observed in the non-ALI patients. From these results, we speculate that NE-AT, but not e-XDP, may be predictive of progressive lung injury in the early stage of ALI and ARDS.
AB - Critically ill patients are commonly associated with systemic inflammatory response syndrome (SIRS) and are at a greater risk of developing acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Under these conditions, large amounts of various cytokines are produced, which either directly or indirectly induce tissue injury and finally organ dysfunctions, through the activation of neutrophils and as a result of release of cytotoxic molecules, especially neutrophil elastase (NE). In the present study, we determined plasma neutrophil elastase-alpha-1 antitrypsin complex (NE-AT) and elastase digests of cross-linked fibrin (e-XDP) in critically ill patients to elucidate the significance of NE in the initiation and progression of ALI and ARDS in the presence or absence of SIRS. We found significantly increased levels of plasma NE-AT in the patients with ARDS, especially when the definition of SIRS was met. Among ALI/ARDS groups, plasma NE-AT, but not e-XDP, correlated significantly with the decrease in PaO2/FIO2 ratio and the duration of ALI/ARDS. Furthermore, NE-AT, but not e-XDP, significantly increased in subgroups whose PaO2/FIO2 ratio decreased by more than 20%. Such correlations and differences between the subgroups were not observed in the non-ALI patients. From these results, we speculate that NE-AT, but not e-XDP, may be predictive of progressive lung injury in the early stage of ALI and ARDS.
KW - ALI
KW - ARDS
KW - SIRS
UR - http://www.scopus.com/inward/record.url?scp=44349141377&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=44349141377&partnerID=8YFLogxK
U2 - 10.1016/j.biopha.2007.07.003
DO - 10.1016/j.biopha.2007.07.003
M3 - Article
C2 - 17698318
AN - SCOPUS:44349141377
VL - 62
SP - 333
EP - 338
JO - Biomedicine and Pharmacotherapy
JF - Biomedicine and Pharmacotherapy
SN - 0753-3322
IS - 5
ER -