Haj M A, Robbie L A, Adey G D, Bennett B
Department of Medicine and Therapeutics, University of Aberdeen Medical School, Foresterhill, UK.
Thromb Haemost. 1995 Dec;74(6):1528-32.
Leucocytes, both polymorphs and mononuclear cells, play a variety of roles in the evolution of human response to sepsis, both local and generalised. In this study, inhibitors of plasminogen activator were measured in leucocytes from normal and septic patients. Plasminogen activator inhibitor-1 (PAI-1) was identified in polymorphs from normal individuals and levels rose significantly in polymorphs from septic patients: neutrophils from normal subjects did not contain PAI-2 but this protein was detectable in significant quantities in polymorph preparations from septic patients. In contrast, mononuclear cells from normal and septic patients contained no detectable quantities of PAI-1. Significant amounts of PAI-2 were present in normal mononuclear cells, and the levels rose significantly in monocytes from septic patients. PAI-2 is thus here identified in human subjects, distinct from those with pregnancy or malignancy, as playing a role in a pathological process. The increased levels of both inhibitors produced by leucocytes may clearly contribute directly to the persistence of fibrin, a characteristic feature of the response to infection, local or general; they may thus participate in successful localisation of infections (abscess formation etc.) and in the evolution of the major systemic complications of disseminated sepsis characterised by microvascular occlusion by fibrin such as renal failure, shock lung or digital ischaemia.
白细胞，包括多形核白细胞和单核细胞，在人类对脓毒症的局部和全身反应的演变中发挥着多种作用。在本研究中，检测了正常患者和脓毒症患者白细胞中纤溶酶原激活物抑制剂。在正常个体的多形核白细胞中鉴定出纤溶酶原激活物抑制剂-1（PAI-1），脓毒症患者多形核白细胞中的PAI-1水平显著升高：正常受试者的中性粒细胞不含PAI-2，但在脓毒症患者的多形核细胞制剂中可检测到大量该蛋白。相比之下，正常患者和脓毒症患者的单核细胞中未检测到PAI-1。正常单核细胞中存在大量PAI-2，脓毒症患者单核细胞中的PAI-2水平显著升高。因此，在非妊娠或非恶性肿瘤的人类受试者中，PAI-2在病理过程中发挥作用。白细胞产生的两种抑制剂水平升高可能直接导致纤维蛋白持续存在，这是局部或全身感染反应的一个特征；它们可能因此参与感染的成功定位（脓肿形成等）以及以纤维蛋白微血管阻塞为特征的播散性脓毒症主要全身并发症的演变，如肾衰竭、休克肺或手指缺血。
