Skip to main content
PMC home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1991 Nov;66(11):1296–1299. doi: 10.1136/adc.66.11.1296

Deficiency of prostacyclin production in meningococcal shock.

R S Heyderman 1, N J Klein 1, G I Shennan 1, M Levin 1
PMCID: PMC1793288  PMID: 1755641

Abstract

A deficiency of prostacyclin (PGI2) production by the vascular endothelium might underline the severe vasoconstriction and intravascular thrombosis that characterise meningococcal shock. The effect on PGI2 synthesis by human umbilical vein endothelial cells (HUVEC) in culture was examined in sera from children with meningococcal shock, healthy adults, and children with other febrile illnesses. In comparison with adult controls, PGI2 synthesis was reduced when HUVEC were incubated with the sera from 10 of 13 patients with meningococcal shock. A similar defect was observed with only four of 20 sera from children with other febrile illnesses. The effect of sera from patients with meningococcal shock on HUVEC was reversible with normal serum, and seems to be due to the absence of a factor necessary for PGI2 production rather than an inhibitor. These findings suggest that a deficiency of PGI2 may have a role in the pathogenesis of meningococcal shock and that exogenous PGI2 may be of therapeutic benefit.

Full text

PDF
1296

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bihari D. J., Tinker J. The therapeutic value of vasodilator prostaglandins in multiple organ failure associated with sepsis. Intensive Care Med. 1988;15(1):2–7. doi: 10.1007/BF00255627. [DOI] [PubMed] [Google Scholar]
  2. Busse R., Förstermann U., Matsuda H., Pohl U. The role of prostaglandins in the endothelium-mediated vasodilatory response to hypoxia. Pflugers Arch. 1984 May;401(1):77–83. doi: 10.1007/BF00581536. [DOI] [PubMed] [Google Scholar]
  3. Campos A., Kim Y., Azar S. H., Vernier R. L., Michael A. F. Prevention of the generalized Shwartzman reaction in pregnant rats by prostacyclin infusion. Lab Invest. 1983 Jun;48(6):705–710. [PubMed] [Google Scholar]
  4. Ditter H., Matthias F. R., Voss R., Lohmann E. Beneficial effects of prostacyclin in a rabbit endotoxin shock model. Thromb Res. 1988 Aug 15;51(4):403–415. doi: 10.1016/0049-3848(88)90376-3. [DOI] [PubMed] [Google Scholar]
  5. Gimbrone M. A., Jr, Cotran R. S., Folkman J. Human vascular endothelial cells in culture. Growth and DNA synthesis. J Cell Biol. 1974 Mar;60(3):673–684. doi: 10.1083/jcb.60.3.673. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Gérard P., Moriau M., Bachy A., Malvaux P., De Meyer R. Meningococcal purpura: report of 19 patients treated with heparin. J Pediatr. 1973 May;82(5):780–786. doi: 10.1016/s0022-3476(73)80066-6. [DOI] [PubMed] [Google Scholar]
  7. Havens P. L., Garland J. S., Brook M. M., Dewitz B. A., Stremski E. S., Troshynski T. J. Trends in mortality in children hospitalized with meningococcal infections, 1957 to 1987. Pediatr Infect Dis J. 1989 Jan;8(1):8–11. doi: 10.1097/00006454-198901000-00003. [DOI] [PubMed] [Google Scholar]
  8. Levin M., Elkon K. B., Nokes T. J., Buckle A. M., Dillon M. J., Hardisty R. M., Barratt T. M. Inhibitor of prostacyclin production in sporadic haemolytic uraemic syndrome. Arch Dis Child. 1983 Sep;58(9):703–708. doi: 10.1136/adc.58.9.703. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Mercier J. C., Beaufils F., Hartmann J. F., Azéma D. Hemodynamic patterns of meningococcal shock in children. Crit Care Med. 1988 Jan;16(1):27–33. doi: 10.1097/00003246-198801000-00006. [DOI] [PubMed] [Google Scholar]
  10. Moncada S. Eighth Gaddum Memorial Lecture. University of London Institute of Education, December 1980. Biological importance of prostacyclin. Br J Pharmacol. 1982 May;76(1):3–31. doi: 10.1111/j.1476-5381.1982.tb09186.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Moncada S., Gryglewski R., Bunting S., Vane J. R. An enzyme isolated from arteries transforms prostaglandin endoperoxides to an unstable substance that inhibits platelet aggregation. Nature. 1976 Oct 21;263(5579):663–665. doi: 10.1038/263663a0. [DOI] [PubMed] [Google Scholar]
  12. Pareti F. I., Capitanio A., Mannucci L., Ponticelli C., Mannucci P. M. Acquired dysfunction due to the circulation of "exhausted" platelets. Am J Med. 1980 Aug;69(2):235–240. doi: 10.1016/0002-9343(80)90383-6. [DOI] [PubMed] [Google Scholar]
  13. Radomski M. W., Palmer R. M., Moncada S. The anti-aggregating properties of vascular endothelium: interactions between prostacyclin and nitric oxide. Br J Pharmacol. 1987 Nov;92(3):639–646. doi: 10.1111/j.1476-5381.1987.tb11367.x. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES