Maier R V, Ulevitch R J
J Immunol. 1981 Oct;127(4):1596-600.
Disseminated intravascular coagulation (DIC) is a common occurrence during clinical sepsis and can be induced in the experimental host by LPS. Fibrin deposition in the hepatic microcirculation has been observed within 30 min of i.v. injection of LPS. Because mononuclear phagocytes have been shown to produce a PCA after exposure to LPS, we have examined the ability of a homogeneous population of explanted hepatic macrophages to express PCA. Addition of as little as 10 ng/ml of LPS stimulated a 15- to 20-fold increase in PCA over control culture levels within 7 1/2 hr post-treatment. The PCA was found to be membrane-associated, with approximately 90 to 95% of the total PCA present in the cellular lysates, and more than 85% was inhibited by pretreatment of the cells with the diazonium salt of sulfanilic acid, an inhibitor of ecto-enzymes. In contrast to tissue thromboplastin produced by other M phi populations, the H-M phi PCA was found to be markedly sensitive both to heat inactivation at 56 degrees C and to inhibition by 1 mM DFP. Additionally, assays involving both a 1-stage coagulation test as well as an enzyme assay with a Factor Xa-specific substrate (using normal and deficient human plasmas) demonstrated that the H-M phi PCA appears to activate Factor X directly. Unlike tissue thromboplastin, the H-M phi PCA is non-dependent of Factor VII activation. These studies: 1) demonstrate the LPS induces a unique PCA in the H-M phi, and 2) support a role for the H-M phi in the initiation of DIC in endotoxemic shock.
弥散性血管内凝血(DIC)是临床脓毒症期间的常见现象,并且可由脂多糖(LPS)在实验宿主中诱导产生。静脉注射LPS后30分钟内即可观察到肝微循环中有纤维蛋白沉积。由于单核吞噬细胞在暴露于LPS后已被证明可产生促凝血活性(PCA),我们已研究了分离出的均一性肝巨噬细胞群体表达PCA的能力。在处理后7.5小时内,添加低至10 ng/ml的LPS即可刺激PCA比对照培养水平增加15至20倍。发现PCA与膜相关,细胞裂解物中存在约90%至95%的总PCA,并且超过85%的PCA被细胞外酶抑制剂对氨基苯磺酸重氮盐预处理细胞所抑制。与其他巨噬细胞群体产生的组织凝血活酶相反,发现肝巨噬细胞PCA(H-M phi PCA)对56℃热灭活以及1 mM二异丙基氟磷酸(DFP)抑制均明显敏感。此外,涉及一期凝血试验以及使用Xa因子特异性底物(使用正常和缺乏Xa因子的人血浆)的酶试验表明,H-M phi PCA似乎直接激活X因子。与组织凝血活酶不同,H-M phi PCA不依赖于VII因子激活。这些研究:1)证明LPS在H-M phi中诱导产生独特的PCA,2)支持H-M phi在内毒素血症休克中DIC起始过程中的作用。