Hemostatic parameters in sepsis patients treated with anti-TNF alpha-monoclonal antibodies.
Tumor necrosis factor-alpha (TNF alpha) is a central mediator in the pathogenesis of sepsis. It also interferes with the hemostatic system and exerts and a net procoagulant effect. Since TNF alpha may contribute to thrombotic complications in sepsis patients, we determined markers of thrombin activation, parameters of the fibrinolytic system (D-dimer, tissue plasminogen activator antigen (tPA) urinary type plasminogen activator antigen (uPA), plasminogen activator inhibitor antigen (PAI-1) and von Willebrand factor antigen (vWF) in 30 patients with sepsis or septic shock. All patients were treated with standard therapy, but 14 patients were treated additionally with an anti-TNF alpha monoclonal antibody (MAK 195F); 16 patients served as historical controls. No significant effect of the antibody on the parameters of the hemostatic system could be determined. Our data speak against a modulation of coagulation or the fibrinolytic system by the monoclonal anti-TNF alpha antibody MAK 195F in this cohort of sepsis patients.
Department of Internal Medicine III, Klinikum Grosshadern, Ludwig-Maximilians-Universität, Munich, Germany.
C
C
Salat
P
P
Boekstegers
E
E
Holler
K
K
Werdan
B
B
Reinhardt
S
S
Fateh-Moghadam
R
R
Pihusch
M
M
Kaul
T
T
Beinert
E
E
Hiller
D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D000941:Antigens / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D004727:Endothelium / Q000166:cytology / Q000187:drug effects; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis / Q000187:drug effects / Q000378:metabolism; D005342:Fibrinolysis / Q000187:drug effects; D006801:Humans; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood / Q000378:metabolism; D011516:Prothrombin / Q000032:analysis / Q000187:drug effects / Q000378:metabolism; D018805:Sepsis / Q000097:blood* / Q000188:drug therapy* / Q000378:metabolism; D013917:Thrombin / Q000032:analysis / Q000187:drug effects / Q000378:metabolism; D010959:Tissue Plasminogen Activator / Q000097:blood / Q000187:drug effects / Q000276:immunology; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*; D015854:Up-Regulation; D014568:Urokinase-Type Plasminogen Activator / Q000097:blood / Q000187:drug effects / Q000276:immunology; D014841:von Willebrand Factor / Q000032:analysis / Q000187:drug effects / Q000378:metabolism
D000911:Antibodies, Monoclonal; D000941:Antigens; D005338:Fibrin Fibrinogen Degradation Products; D017395:Plasminogen Activator Inhibitor 1; D014409:Tumor Necrosis Factor-alpha; D014841:von Willebrand Factor; D011516:Prothrombin; D013917:Thrombin; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator