Dunn D L, Mach P A, Dalmasso A P, Ferguson R M, Cerra F B
J Surg Res. 1985 Mar;38(3):298-304. doi: 10.1016/0022-4804(85)90041-1.
Antiserum raised to a rough mutant Escherichia coli, termed J5 (anti-J5 RS), protected against lethal gram-negative bacterial sepsis in a guinea pig model when animals were pretreated with both antiserum and heparin. This same model was used to examine and compare the effects of pretreatment with anti-J5 RS, normal rabbit serum (NRS), or saline, each +/- heparin on physiologic and metabolic parameters during a septic insult. Results demonstrated that leukopenia and thrombocytopenia occurred to a similar degree in all pretreatment groups; no significant leuko- or thrombostasis was noted on examination of histologic specimens; complement activation was maximal in those animals receiving anti-J5 RS alone without heparin; the most abnormal amino acid profile was present in the NRS + heparin group; and only the anti-J5 RS + heparin group did not develop glomerular lesions indicative of disseminated intravascular coagulation. A complement-mediated cell aggregation-type injury does not appear to occur in this model. It is hypothesized that both excessive complement and coagulation system activation occur after bacterial challenge when antibody directed against the bacteria is present (anti-J5 RS) leading to antigen-antibody complex formation and complement and coagulation cascade activation. Heparin may block either or both these cascade systems allowing enhanced, antibody-mediated opsonization and clearance of blood-borne bacteria, thus preventing end-organ alterations and organ failure during sepsis when combined with anti-J5 RS.
针对一种粗糙突变型大肠杆菌(称为J5)制备的抗血清(抗J5 RS),当豚鼠同时用抗血清和肝素进行预处理时,可保护其免受致死性革兰氏阴性菌败血症的侵害。使用同一模型来检查和比较用抗J5 RS、正常兔血清(NRS)或生理盐水进行预处理,每种预处理再分别添加或不添加肝素,对败血症发作期间生理和代谢参数的影响。结果表明,所有预处理组中白细胞减少和血小板减少的程度相似;组织学标本检查未发现明显的白细胞或血栓形成;单独接受抗J5 RS而未用肝素的动物补体激活程度最高;NRS +肝素组的氨基酸谱最异常;只有抗J5 RS +肝素组未出现提示弥散性血管内凝血的肾小球病变。在该模型中似乎未发生补体介导的细胞聚集型损伤。据推测,当存在针对细菌的抗体(抗J5 RS)时,细菌攻击后会发生补体和凝血系统的过度激活,导致抗原 - 抗体复合物形成以及补体和凝血级联反应激活。肝素可能会阻断这些级联系统中的一个或两个,从而增强抗体介导的调理作用和清除血源细菌的能力,因此与抗J5 RS联合使用时可预防败血症期间的终末器官改变和器官衰竭。