title: The Autodigestion Hypothesis in Shock and Multi-Organ Failure: Degrading Protease Activity.
abstract: Shock and multi-organ failure have one of the highest levels of inflammatory markers, morbidities and mortality. The underlying mechanisms are currently unknown and no effective intervention exists. We present evidence for a previously untested mechanism due toautodigestionby the digestive enzymes synthesized in the pancreas and transported in the lumen of the intestine as normal part of food digestion. We summarize experimental evidence in support of the autodigestion hypothesis and a new approach for possible intervention against multi-organ failure that is currently entering clinical trials.
authors.affiliation: Microcirculation Laboratory, Department of Bioengineering, The Institute of Engineering in Medicine, University of California San Diego, La Jolla, California 92093 - 0412.
authors.forename: Geert W
authors.initials: GW
authors.lastname: Schmid-Schönbein
authors.affiliation: Microcirculation Laboratory, Department of Bioengineering, The Institute of Engineering in Medicine, University of California San Diego, La Jolla, California 92093 - 0412.
authors.forename: Alex
authors.initials: A
authors.lastname: Penn
authors.affiliation: Microcirculation Laboratory, Department of Bioengineering, The Institute of Engineering in Medicine, University of California San Diego, La Jolla, California 92093 - 0412.
authors.forename: Erik
authors.initials: E
authors.lastname: Kistler
keywords: Intestine; chymotrypsin; digestive pancreas; elastase; hemorrhagic shock; inflammation; intestinal mucosa; sepsis; trypsin