title: Recombinant human soluble thrombomodulin decreases the plasma high-mobility group box-1 protein levels, whereas improving the acute liver injury and survival rates in experimental endotoxemia.
abstract: OBJECTIVE
  In addition to the hyperactivation of the inflammatory cytokines, high-mobility group box-1 protein (HMGB1), recently identified as a lethal late-phase mediator is suspected to be closely correlated with the development of sepsis. Therefore, the therapeutic efficacy of recombinant human soluble thrombomodulin (ART-123) administration on the production of inflammatory cytokines and the plasma level of HMGB1 was investigated in experimental endotoxemia.
  
  
  METHODS
  Prospective, comparative, experimental study.
  
  
  METHODS
  Laboratory animal research center at a university.
  
  
  METHODS
  Male Sprague-Dawley rats (250-300 g).
  
  
  METHODS
  Endotoxemia was induced in rats by a bolus intravenous injection of lipopolysaccharide (LPS) at a dosage of 4 mg/kg (LPS group). ART-123 (1 mg/kg) was administered as a bolus injection 30 minutes before or 4 hours after injection of LPS (ART-123 pretreated/treated group). As a control, an equal volume of physiologic saline was administered instead of LPS and ART-123 (control group).
  
  
  RESULTS
  Rats were randomly divided into ART-123 pretreated group, ART-123 treated group, and LPS group, respectively. After the injection of LPS, the levels of inflammatory cytokines and thrombin-antithrombin III complex, plasma HMGB1 concentrations, liver immunohistochemical and histopathologic characteristics, liver dysfunction, and survival rate were examined. The increased levels of inflammatory cytokines and plasma HMGB1 induced by LPS in this rat model were improved by the administration of ART-123; additionally, reduced liver dysfunction and increased survival rate were observed.
  
  
  CONCLUSIONS
  This study demonstrated that ART-123 inhibits the expression of inflammatory cytokines and decreases the plasma HMGB1 levels in experimental endotoxemia. In addition, ART-123 administration markedly reduced liver dysfunction and mortality even with delayed treatment of ART-123. The use of ART-123 may therefore be a beneficial treatment for septic patients.
authors.affiliation: Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Nagato
authors.forename: Kohji
authors.initials: K
authors.lastname: Okamoto
authors.forename: Yukio
authors.initials: Y
authors.lastname: Abe
authors.forename: Aiichiro
authors.initials: A
authors.lastname: Higure
authors.forename: Koji
authors.initials: K
authors.lastname: Yamaguchi
mesh_terms: D000818:Animals; D000990:Antithrombin III; D004195:Disease Models, Animal; D019446:Endotoxemia / Q000097:blood* / Q000188:drug therapy* / Q000209:etiology; D024243:HMGB1 Protein / Q000097:blood*; D053583:Interleukin-1beta / Q000097:blood; D008070:Lipopolysaccharides; D008099:Liver / Q000378:metabolism / Q000473:pathology; D008107:Liver Diseases / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control; D008297:Male; D010447:Peptide Hydrolases / Q000097:blood; D051381:Rats; D017207:Rats, Sprague-Dawley; D011994:Recombinant Proteins / Q000627:therapeutic use; D018180:Thrombomodulin / Q000627:therapeutic use*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: C472045:ART123; D024243:HMGB1 Protein; C104200:Hbp1 protein, rat; D053583:Interleukin-1beta; D008070:Lipopolysaccharides; D011994:Recombinant Proteins; D018180:Thrombomodulin; D014409:Tumor Necrosis Factor-alpha; C046193:antithrombin III-protease complex; C433788:lipopolysaccharide, E. coli O26-B6; D000990:Antithrombin III; D010447:Peptide Hydrolases