Activated protein C in the treatment of acute lung injury and acute respiratory distress syndrome

A.D. Cornet, G.P. van Nieuw Amerongen, A. Beishuizen, M.J. Schultz, A.R.J. Girbes, A.B.J. Groeneveld

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background: Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) frequently necessitate mechanical ventilation in the intensive care unit. The syndromes have a high mortality rate and there is at present no treatment specifically directed at the underlying pathogenesis. Central in the pathophysiology of ALI/ARDS is alveolocapillary inflammation leading to permeability edema. As a result of the crosstalk between inflammation and coagulation, activation of proinflammatory and procoagulant/antifibrinolytic pathways contributes to disruption of the endothelial barrier. Protein C (PC) plays a central role in maintaining the equilibrium between coagulation and inflammation. Additionally, natural anticoagulants, such as PC, are depleted, both in blood as well as in the lung. Therefore, the PC system is of interest as a therapeutic target in patients with ALI/ARDS. Method: This review is based on a Medline search of relevant basic and clinical studies. Objective: It discusses the potential role of activated PC in modulating the proinflammatory/procoagulant state for enhancing endothelial barrier function in animal models and human ALI/ARDS
Original languageUndefined/Unknown
Pages (from-to)219-227
JournalExpert Opinion on Drug Discovery
Volume4
Issue number3
DOIs
Publication statusPublished - 2009

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