title: Tumor necrosis factor-alpha inhibition reduces CXCL-8 levels but fails to prevent fibrin generation and does not improve outcome in a rabbit model of endotoxic shock.
abstract: The effects of a monoclonal antibody (mAb) to tumor necrosis factor-alpha (TNF-alpha) were examined in a rabbit model of endotoxic shock. Intravenous administration of lipopolysaccharide (100 microg/kg/hr) for 6 hours (n = 11) increased TNF-alpha levels. Fibrinogen was partially consumed, and fibrin deposits were seen in kidney and lungs at 24 hours. Mortality at 24 hours was 64%. Levels of interleukin-8 (aka CXCL-8) were notably increased. Mean arterial pressure (MAP) and leukocyte counts decreased, whereas creatinine levels were enhanced. The anti-TNF-alpha mAb (20 mg/kg i.v. bolus + 5 mg/kg/h i.v. for the first 90 minutes) (n = 10) efficiently inhibited the TNF-activity. Rabbits exhibited lower CXCL-8 levels; MAP improved, the decrease in leukocyte counts was partially prevented and creatinine levels were lower, but fibrinogen, fibrin deposits in kidneys and lungs and mortality, 55%, were similar to the LPS group. Rabbits that did not survive exhibited lower fibrinogen levels, more fibrin in kidneys and lungs and higher CXCL-8 and creatinine levels than survivors, while there were no differences in TNF-alpha, MAP and leukocytes. Thus, the inhibition of TNF-alpha, although beneficial through lowering CXCL-8 levels, is not enough to improve the outcome, which could be partly due to the inability to prevent the fibrin deposits formation in kidneys and lungs.
authors.affiliation: Hemostasis and Thrombosis Research Unit, Hematology Service, University Clinic, School of Medicine, University of Navarra, Avenida Pío XII 36, 31008-Pamplona, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Rodriguez-Wilhelmi
authors.forename: Ramon
authors.initials: R
authors.lastname: Montes
authors.forename: Akihiro
authors.initials: A
authors.lastname: Matsukawa
authors.forename: Hideo
authors.initials: H
authors.lastname: Nariuchi
authors.forename: Veronica
authors.initials: V
authors.lastname: Hurtado
authors.forename: Marta
authors.initials: M
authors.lastname: Montes
authors.forename: Jose
authors.initials: J
authors.lastname: Hermida
authors.forename: Eduardo
authors.initials: E
authors.lastname: Rocha
mesh_terms: D000818:Animals; D000911:Antibodies, Monoclonal / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D004195:Disease Models, Animal; D004797:Enzyme-Linked Immunosorbent Assay; D005337:Fibrin / Q000378:metabolism*; D005340:Fibrinogen / Q000378:metabolism; D016209:Interleukin-8 / Q000378:metabolism*; D007668:Kidney / Q000187:drug effects / Q000378:metabolism; D007962:Leukocytes / Q000187:drug effects; D008070:Lipopolysaccharides / Q000494:pharmacology; D008168:Lung / Q000187:drug effects / Q000378:metabolism; D008297:Male; D011817:Rabbits; D012772:Shock, Septic / Q000378:metabolism* / Q000401:mortality / Q000628:therapy; D015996:Survival Rate; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000276:immunology
chemical_list: D000911:Antibodies, Monoclonal; D016209:Interleukin-8; D008070:Lipopolysaccharides; D014409:Tumor Necrosis Factor-alpha; D005337:Fibrin; D005340:Fibrinogen