Abstract
Plasma fibronectin deficiency and opsonic dysfunction exist in critically ill septic surgical, trauma, and burn patients with multiple organ failure. Fibronectin deficiency can be reversed by infusion of fresh plasma cryoprecipitate. The influence of therapy with human cryoprecipitate on lung vascular permeability in septic sheep with plasma fibronectin deficiency following surgery was evaluated. Additionally, selected studies on pulmonary function in septic surgical and trauma patients after infusion of plasma cryoprecipitate were completed. In patients, ventilation-perfusion balance appeared to improve as measured by the multiple inert gas elimination technique. With the lung lymph fistula preparation in fibronectin deficient sheep, infusion of human plasma cryoprecipitate (10 units; 250 ml) delayed the onset and minimized the increase in lung vascular permeability during postoperative Pseudomonas sepsis (5 X 10(9) bacteria, I.V.; 5 X 10(10) bacteria, I.P.). For example, in a first group of sheep, the transvascular protein clearance (TPC) at 2 hrs in septic sheep (n = 4) treated with only saline (volume control) was 20.1 +/- 3.1 ml/hr, compared to 11.23 +/- 0.83 ml/hr in the sheep (n =a 4) treated with fibronectin-rich cryoprecipitate (p less than 0.05). In a second group of sheep, cryoprecipitate depleted of fibronectin by affinity chromatography was used as the control solution. It also did not manifest this protective effect with respect to lung vascular permeability. Thus, at 2 hrs the lymph flow (Qlym) was 30.2 ml/hr and the transvascular protein clearance (TPC) was 18.0 ml/hr in septic sheep given fibronectin-deficient cryoprecipitate. In contrast, in the fibronectin-rich cryoprecipitate treated sheep, the Qlym was 14.8 ml/hr and the TPC was 8.12 ml/hr. It is suggested that fibronectin may influence lung vascular integrity during sepsis following surgery and trauma.
Full text
PDF








Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Blumenstock F. A., Saba T. M., Weber P. An affinity method for the rapid purification of opsonic alpha 2 SB glycoprotein from serum. Adv Shock Res. 1979;2:55–71. [PubMed] [Google Scholar]
- Blumenstock F. A., Saba T. M., Weber P., Laffin R. Biochemical and immunological characterization of human opsonic alpha2SB glycoprotein: its identity with cold-insoluble globulin. J Biol Chem. 1978 Jun 25;253(12):4287–4291. [PubMed] [Google Scholar]
- Blumenstock F., Weber P., Saba T. M., Laffin R. Electroimmunoassay of alpha-2-opsonic protein during reticuloendothelial blockade. Am J Physiol. 1977 Mar;232(3):R80–R87. doi: 10.1152/ajpregu.1977.232.3.R80. [DOI] [PubMed] [Google Scholar]
- Brigham K. L., Woolverton W. C., Blake L. H., Staub N. C. Increased sheep lung vascular permeability caused by pseudomonas bacteremia. J Clin Invest. 1974 Oct;54(4):792–804. doi: 10.1172/JCI107819. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Deitch E. A., Gelder F., McDonald J. C. The relationship between CIG depletion and peripheral neutrophil function in rabbits and man. J Trauma. 1982 Jun;22(6):469–475. doi: 10.1097/00005373-198206000-00005. [DOI] [PubMed] [Google Scholar]
- Drake R., Adair T., Traber D., Gabel J. Contamination of caudal mediastinal node efferent lymph in sheep. Am J Physiol. 1981 Sep;241(3):H354–H357. doi: 10.1152/ajpheart.1981.241.3.H354. [DOI] [PubMed] [Google Scholar]
- Engvall E., Ruoslahti E. Binding of soluble form of fibroblast surface protein, fibronectin, to collagen. Int J Cancer. 1977 Jul 15;20(1):1–5. doi: 10.1002/ijc.2910200102. [DOI] [PubMed] [Google Scholar]
- Evans J. W., Wagner P. D. Limits on VA/Q distributions from analysis of experimental inert gas elimination. J Appl Physiol Respir Environ Exerc Physiol. 1977 Jun;42(6):889–898. doi: 10.1152/jappl.1977.42.6.889. [DOI] [PubMed] [Google Scholar]
- Kaplan J. E., Molnar J., Saba T. M., Allen C. Comparative disappearance and localization of isotopically labeled opsonic protein and soluble albumin following surgical trauma. J Reticuloendothel Soc. 1976 Nov;20(5):375–384. [PubMed] [Google Scholar]
- Lanser M. E., Saba T. M., Scovill W. A. Opsonic glycoprotein (plasma fibronectin) levels after burn injury. Relationship to extent of burn and development of sepsis. Ann Surg. 1980 Dec;192(6):776–782. doi: 10.1097/00000658-198012000-00014. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McDonald J. A., Baum B. J., Rosenberg D. M., Kelman J. A., Brin S. C., Crystal R. G. Destruction of a major extracellular adhesive glycoprotein (fibronectin) of human fibroblasts by neutral proteases from polymorphonuclear leukocyte granules. Lab Invest. 1979 Mar;40(3):350–357. [PubMed] [Google Scholar]
- Minnear F. L., Barie P. S., Malik A. B. Lung fluid and protein exchange in the acute sheep preparation. J Appl Physiol Respir Environ Exerc Physiol. 1981 Jun;50(6):1358–1361. doi: 10.1152/jappl.1981.50.6.1358. [DOI] [PubMed] [Google Scholar]
- Niehaus G. D., Dillon B. C., Schumacker P. T., Saba T. M. Influence of gelatin on bioassayable and immunoreactive opsonic fibronectin. Proc Soc Exp Biol Med. 1981 Oct;168(1):15–23. doi: 10.3181/00379727-168-41228. [DOI] [PubMed] [Google Scholar]
- Niehaus G. D., Schumacker P. T., Saba T. M. Influence of opsonic fibronectin deficiency on lung fluid balance during bacterial sepsis. J Appl Physiol Respir Environ Exerc Physiol. 1980 Oct;49(4):693–699. doi: 10.1152/jappl.1980.49.4.693. [DOI] [PubMed] [Google Scholar]
- Oh E., Pierschbacher M., Ruoslahti E. Deposition of plasma fibronectin in tissues. Proc Natl Acad Sci U S A. 1981 May;78(5):3218–3221. doi: 10.1073/pnas.78.5.3218. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Robbins A. B., Doran J. E., Reese A. C., Mansberger A. R., Jr Cold insoluble globulin levels in operative trauma: serum depletion, wound sequestration, and biological activity: an experimental and clinical study. Am Surg. 1980 Dec;46(12):663–672. [PubMed] [Google Scholar]
- Saba T. M., Blumenstock F. A., Scovill W. A., Bernard H. Cryoprecipitate reversal of opsonic alpha2-surface binding glycoprotein deficiency in septic surgical and trauma patients. Science. 1978 Aug 18;201(4356):622–624. doi: 10.1126/science.675246. [DOI] [PubMed] [Google Scholar]
- Saba T. M., Blumenstock F. A., Weber P., Kaplan J. E. Physiologic role of cold-insoluble globulin in systemic host defense: implications of its characterization as the opsonic alpha 2-surface-binding glycoprotein. Ann N Y Acad Sci. 1978 Jun 20;312:43–55. doi: 10.1111/j.1749-6632.1978.tb16792.x. [DOI] [PubMed] [Google Scholar]
- Saba T. M., Cho E. Reticuloendothelial systemic response to operative trauma as influenced by cryoprecipitate or cold-insoluble globulin therapy. J Reticuloendothel Soc. 1979 Aug;26(2):171–186. [PubMed] [Google Scholar]
- Saba T. M., Di Luzio N. R. Reticuloendothelial blockade and recovery as a function of opsonic activity. Am J Physiol. 1969 Jan;216(1):197–205. doi: 10.1152/ajplegacy.1969.216.1.197. [DOI] [PubMed] [Google Scholar]
- Saba T. M., Jaffe E. Plasma fibronectin (opsonic glycoprotein): its synthesis by vascular endothelial cells and role in cardiopulmonary integrity after trauma as related to reticuloendothelial function. Am J Med. 1980 Apr;68(4):577–594. doi: 10.1016/0002-9343(80)90310-1. [DOI] [PubMed] [Google Scholar]
- Scovill W. A., Annest S. J., Saba T. M., Blumenstock F. A., Newell J. C., Stratton H. H., Powers S. R. Cardiovascular hemodynamics after opsonic alpha-2-surface binding glycoprotein therapy in injured patients. Surgery. 1979 Aug;86(2):284–293. [PubMed] [Google Scholar]
- Scovill W. A., Saba T. M., Blumenstock F. A., Bernard H., Powers S. R., Jr Opsonic alpha2 surface binding glycoprotein therapy during sepsis. Ann Surg. 1978 Oct;188(4):521–529. doi: 10.1097/00000658-197810000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stenman S., Vaheri A. Distribution of a major connective tissue protein, fibronectin, in normal human tissues. J Exp Med. 1978 Apr 1;147(4):1054–1064. doi: 10.1084/jem.147.4.1054. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Suwa K., Bendixen H. H. Change in PaCO2 with mechanical dead space during artificial ventilation. J Appl Physiol. 1968 Apr;24(4):556–562. doi: 10.1152/jappl.1968.24.4.556. [DOI] [PubMed] [Google Scholar]

