Zusammenfassung
Background The role of plasminogen activator inhibitor type-1 (PAI-1) in abdominal sepsis remains elusive. Objectives To study the influence of inhibition and over-expression of PAI-1 upon survival in cecal ligation and puncture (CLP) sepsis. Methods (i) Mice underwent moderate CLP and received 10mgkg-1 of either monoclonal anti-PAI-1 (MA-MP6H6) or control (MA-Control) antibody intravenously at ...
Zusammenfassung
Background The role of plasminogen activator inhibitor type-1 (PAI-1) in abdominal sepsis remains elusive. Objectives To study the influence of inhibition and over-expression of PAI-1 upon survival in cecal ligation and puncture (CLP) sepsis. Methods (i) Mice underwent moderate CLP and received 10mgkg-1 of either monoclonal anti-PAI-1 (MA-MP6H6) or control (MA-Control) antibody intravenously at 0, 18 or 30h post-CLP. The 30-h treatment group was additionally stratified into mice predicted to survive (P-SUR) or die (P-DIE) based on IL 6 measured at 24h post-CLP. (ii) PAI-1 expression was induced with pLIVE.PAI-1 plasmid administered 72h pre-CLP. Blood was sampled for 5 days and survival was monitored for 28days. Results MA-MP6H6 effectively neutralized active PAI-1 and fully restored fibrinolysis while PAI-1 over-expression was liver-specific and correlated with PAI-1 increase in the blood. Without stratification, MA-MP6H6 co-/post-treatment conferred no survival benefit. Prospective stratification (IL-6 cut-off: 14ngmL-1) suggested increased mortality by MA-MP6H6 treatment in P-SUR that reached 30% difference (vs. MA-Control; P<0.05) after a retrospective cut-off readjustment to 3.3ngmL-1 for better P-SUR homogeneity. Subsequent prospective anti-PAI-1 treatment in P-SUR mice with 3.3ngmL-1 cut-off demonstrated a negative but statistically insignificant effect: mortality was higher by 17% after MA-MP6H6 vs. MA-Control. Over-expression of PAI 1 did not alter post-CLP survival. Neither PAI-1 inhibition nor over-expression meaningfully modified inflammatory response and/or organ function. Conclusions Restoration of fibrinolysis in early abdominal sepsis was not beneficial and it may prove detrimental in subjects with the lowest risk of death, while preemptive PAI-1 up-regulation at the current magnitude was not protective.
Altmetric