Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.
Thromb Res. 2011 Jun;127(6):582-8. doi: 10.1016/j.thromres.2011.01.017. Epub 2011 Mar 10.
Disseminated intravascular coagulation (DIC), a disorder of the blood coagulation function, is a common complication of severe sepsis. Ethyl pyruvate (EP), a derivative of pyruvate, is known for its anti-inflammatory and antioxidant properties. Recently, EP showed anticoagulant effects in vitro. Therefore, the aim of study is to investigate the in vivo anticoagulant effect of EP on a severe DIC model induced by lipopolysaccharide (LPS) in anesthetized Wistar rats.
The animals were intravenously infused with LPS (30 mg/kg) over a period of 4h. One hour after LPS initiation, rats were treated with EP in three dosages (20, 40 and 60 mg/kg/4h, i.v.).
The intermediate and high doses of EP (40 and 60 mg/kg) prevented circulatory failure, improved renal and hepatic function, and reduced the plasma levels of TNF-α and IL-6 after LPS administration. All used doses of EP significantly prevented prothrombin time prolongation, and reduced mRNA expression of tissue factor in lung tissue induced by LPS. The two higher doses of EP attenuated plasma concentrations of thrombin-antithrombin complex. The high dose of EP (60 mg/kg) significantly preserved platelet counts, and improved survival rate. However, EP did not reduce the elevation of plasma plasminogen activator inhibitor-1 during endotoxemia.
EP demonstrates the in vivo anticoagulant effect and improved organ functions in a severe DIC model in rats, which is likely associated with the inhibitory effect on tissue factor mRNA expression and cytokines release. Its effectiveness in preventing DIC is not mediated by increase in fibrinolysis.
弥散性血管内凝血(DIC)是一种凝血功能障碍性疾病,是严重脓毒症的常见并发症。丙酮酸乙酯(EP)是丙酮酸的衍生物,具有抗炎和抗氧化作用。最近,EP 在体外显示出抗凝作用。因此,本研究旨在探讨 EP 对麻醉 Wistar 大鼠内毒素(LPS)诱导的严重 DIC 模型的体内抗凝作用。
动物静脉输注 LPS(30mg/kg)4 小时。在 LPS 开始后 1 小时,大鼠分别用 EP 三种剂量(20、40 和 60mg/kg/4h,iv)治疗。
中、高剂量 EP(40 和 60mg/kg)可预防循环衰竭,改善肾功能和肝功能,并降低 LPS 后血浆 TNF-α和 IL-6 水平。EP 的所有使用剂量均显著预防 LPS 诱导的凝血酶原时间延长,并降低肺组织组织因子的 mRNA 表达。两种较高剂量的 EP 减轻了血浆凝血酶-抗凝血酶复合物的浓度。高剂量 EP(60mg/kg)可显著维持血小板计数,提高存活率。然而,EP 并未减少内毒素血症期间血浆纤溶酶原激活物抑制剂-1 的升高。
EP 在内毒素诱导的严重 DIC 大鼠模型中表现出体内抗凝作用和改善器官功能,这可能与抑制组织因子 mRNA 表达和细胞因子释放有关。其预防 DIC 的有效性不是通过增加纤维蛋白溶解来介导的。