Raasveld M H, Hack C E, ten Berge I J
Department of Internal Medicine, University of Amsterdam, The Netherlands.
Thromb Haemost. 1992 Sep 7;68(3):264-7.
Treatment with OKT3 induces cytokine release and activates the complement system. Since both phenomena may affect coagulation and fibrinolysis we studied these systems in 8 renal transplant recipients during OKT3 treatment. In 8 of 9 patients a similar pattern was observed: plasma thrombin-antithrombin-III-complex, tissue-type plasminogen-activator and plasmin-alpha 2-antiplasmin-complex levels were increased as compared to pretreatment levels (p less than 0.05) at 15 min after the first OKT3 dose and reached peak values at 1 h. No significant changes were observed upon subsequent OKT3 administrations or in a control group of 8 patients. In one patient upon the first OKT3 administration only complement activation, and no cytokine release was observed, whereas plasma thrombin-antithrombin-III-complex, tissue-type plasminogen-activator and plasmin-alpha 2-antiplasmin-complex levels increased only at 15 min. In conclusion, we demonstrate a biphasic activation of coagulation and fibrinolysis upon the first OKT3 dose; the initial phase seems to be associated with complement activation, the later phase with cytokine release.
用OKT3治疗可诱导细胞因子释放并激活补体系统。由于这两种现象都可能影响凝血和纤溶，我们在8例接受OKT3治疗的肾移植受者中研究了这些系统。9例患者中有8例观察到类似模式：与首次使用OKT3剂量后15分钟时的预处理水平相比，血浆凝血酶 - 抗凝血酶 - III复合物、组织型纤溶酶原激活剂和纤溶酶 - α2 - 抗纤溶酶复合物水平升高（p < 0.05），并在1小时时达到峰值。在随后的OKT3给药时或在8例患者的对照组中未观察到显著变化。1例患者在首次使用OKT3时仅观察到补体激活，未观察到细胞因子释放，而血浆凝血酶 - 抗凝血酶 - III复合物、组织型纤溶酶原激活剂和纤溶酶 - α2 - 抗纤溶酶复合物水平仅在15分钟时升高。总之，我们证明了首次使用OKT3剂量时凝血和纤溶的双相激活；初始阶段似乎与补体激活有关，后期阶段与细胞因子释放有关。
