title: Antithrombin reduces inflammation and microcirculatory perfusion failure in closed soft-tissue injury and endotoxemia.
abstract: BACKGROUND
  Closed soft-tissue trauma leads to activation of the coagulation cascade and is often complicated by systemic inflammation and infection. Previous investigations have shown potent anti-inflammatory properties of antithrombin. We herein report on the action of antithrombin on skeletal muscle injury in experimental endotoxemia.
  
  
  METHODS
  By using a pneumatically driven computer-controlled impact device, closed soft-tissue trauma was applied on the left hind limb of pentobarbital-anesthetized rats. Six hours later, endotoxemia was induced by intraperitoneal injection of Escherichia coli lipopolysaccharide. An equivalent volume of physiological saline was given in controls. At the same time point, treatment of animals was started by intravenous injection of antithrombin (250 IU/kg body weight) or vehicle solution. Twenty-four hours after trauma, the extensor digitorum longus muscle was microsurgically exposed and analyzed by means of high-resolution multifluorescence microscopy.
  
  
  RESULTS
  Traumatic soft-tissue injury with additional endotoxemia was characterized by nutritive perfusion failure (functional capillary density: 379±20cm/cm;), tissue hypoxia (nicotinamide adenine dinucleotide autofluorescence: 77±4 aU), and enhanced leukocyte-endothelial cell interaction (773±35 cells/mm;). Therapeutic intervention with antithrombin 6 hrs after trauma restored nutritive perfusion and tissue oxygenation (functional capillary density: 469±22cm/cm; nicotinamide adenine dinucleotide autofluorescence: 61±5 aU [p < 0.05]) and reduced inflammatory leukocyte adherence (237±20 cells/mm; [p < 0.05]) toward values found in nontraumatized controls (functional capillary density: 573±13cm/cm; nicotinamide adenine dinucleotide autofluorescence: 56±2 aU; leukocyte adherence: 204±20 cells/mm;).
  
  
  CONCLUSIONS
  Antithrombin ameliorates microcirculatory dysfunction and tissue injury in traumatized animals during endotoxemia. Furthermore, a reduced inflammatory cell response helps to prevent leukocyte-dependent secondary tissue injury.
authors: Department of Trauma & Reconstructive Surgery, University of Rostock, Rostock, Germany. philip.gierer@med.uni-rostock.de
authors: Philip
authors: P
authors: Gierer
authors: Fabian
authors: F
authors: Laue
authors: Johannes N
authors: JN
authors: Hoffmann
authors: Robert
authors: R
authors: Rotter
authors: Thomas
authors: T
authors: Mittlmeier
authors: Georg
authors: G
authors: Gradl
authors: Brigitte
authors: B
authors: Vollmar
mesh_terms: D000818:Animals; D000991:Antithrombins / Q000494:pharmacology / Q000627:therapeutic use*; D001772:Blood Cell Count; D001777:Blood Coagulation; D016923:Cell Death; D004195:Disease Models, Animal; D019446:Endotoxemia / Q000139:chemically induced / Q000188:drug therapy* / Q000503:physiopathology; D006439:Hemodynamics; D007150:Immunohistochemistry; D007249:Inflammation / Q000188:drug therapy* / Q000503:physiopathology; D008070:Lipopolysaccharides / Q000633:toxicity; D008833:Microcirculation / Q000187:drug effects* / Q000502:physiology; D008856:Microscopy, Fluorescence; D051381:Rats; D017207:Rats, Sprague-Dawley; D017695:Soft Tissue Injuries / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D000991:Antithrombins; D008070:Lipopolysaccharides; C433788:lipopolysaccharide, E. coli O26-B6