Concepedia

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Lethal E. coli septic shock is prevented by blocking tissue factor with monoclonal antibody.

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1991

Year

TLDR

Gram‑negative bacteremia, driven by LPS, TNF, and IL‑1, commonly leads to lethal septic shock and induces a coagulopathy through tissue factor expression on macrophages and endothelial cells. Pretreatment with 500 µg/kg of an anti‑tissue‑factor monoclonal antibody, either IgG or Fab, reduced coagulopathy and protected baboons from lethal E.

Abstract

Gram-negative bacteremia poses a major health problem, causing one-half of cases of lethal septic shock acquired during hospitalization. Bacterial lipopolysaccharide (LPS) and the inflammatory cytokines, tumor necrosis factor (TNF) and interleukin-1 (IL-1), have been shown to be essential mediators of septic shock. Among the effects of these mediators is a coagulopathy that may be triggered by induced expression of tissue factor (TF) on macrophages and endothelial cells. We now report that 500 micrograms/kg of either immunoglobulin G (IgG) or Fab fragments of a monoclonal antibody against TF administered to baboons as a pretreatment attenuates the coagulopathy and protects against LD100 Escherichia coli. This study provides direct evidence of an essential effector role for TF in septic shock.