title: Evidence for a role of kallikrein-P6nin system in patients with shock after blunt trauma.
abstract: Bradykinin (BK) is activated via plasma and/or tissue kallikrein-kinin (K-K) system pathways during hypotension after blunt trauma. The precise role of the K-K system in human subjects has not been defined. We developed a new method for measuring levels of BK in the blood and examined the role of the K-K system in patients with shock after trauma. Eight patients were entered into this study. We measured the levels of a high-molecular-weight kininogen (HMWK), a low-molecular-weight kininogen (LMWK), BK, and (1-5)-BK in the blood of patients in an unstable state (Pre) and a stable state (Post). At Pre, the blood BK level was significantly elevated, the HMWK and LMWK levels were significantly lower, and the (1-5)-BK level was significantly higher than the respective levels at Post. Our data suggest a significant role for the K-K system in the pathogenesis of shock after blunt trauma. This newly developed method for determination of the activation of the plasma K-K system appears to be useful for determining the severity of a trauma.
authors.affiliation: Department of Emergency and Critical Care Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Sugimoto
authors.forename: M
authors.initials: M
authors.lastname: Hirata
authors.forename: M
authors.initials: M
authors.lastname: Majima
authors.forename: M
authors.initials: M
authors.lastname: Katori
authors.forename: T
authors.initials: T
authors.lastname: Ohwada
mesh_terms: D018806:APACHE; D000328:Adult; D001920:Bradykinin / Q000097:blood; D005260:Female; D006801:Humans; D007610:Kallikreins / Q000502:physiology*; D019679:Kininogen, High-Molecular-Weight / Q000097:blood; D019728:Kininogen, Low-Molecular-Weight / Q000097:blood; D007705:Kinins / Q000502:physiology*; D008297:Male; D010446:Peptide Fragments / Q000097:blood; D011446:Prospective Studies; D012769:Shock / Q000503:physiopathology*; D014949:Wounds, Nonpenetrating / Q000503:physiopathology*
chemical_list: D019679:Kininogen, High-Molecular-Weight; D019728:Kininogen, Low-Molecular-Weight; D007705:Kinins; D010446:Peptide Fragments; C079000:bradykinin (1-5); D007610:Kallikreins; D001920:Bradykinin