Hemostatic parameters in sepsis patients treated with anti-TNF alpha-monoclonal antibodies

• Published in: Shock (Augusta, Ga.) Ga.), 1996-10, Vol.6 (4), p.233-237
• Main Authors: Salat, C, Boekstegers, P, Holler, E, Werdan, K, Reinhardt, B, Fateh-Moghadam, S, Pihusch, R, Kaul, M, Beinert, T, Hiller, E
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antibodies, Monoclonal - administration & dosage; Antibodies, Monoclonal - therapeutic use; Antigens - metabolism; Dose-Response Relationship, Drug; Endothelium - cytology; Endothelium - drug effects; Fibrin Fibrinogen Degradation Products - analysis; Fibrin Fibrinogen Degradation Products - drug effects; Fibrin Fibrinogen Degradation Products - metabolism; Fibrinolysis - drug effects; Humans; Middle Aged; Plasminogen Activator Inhibitor 1 - blood; Plasminogen Activator Inhibitor 1 - metabolism; Prothrombin - analysis; Prothrombin - drug effects; Prothrombin - metabolism; Sepsis - blood; Sepsis - drug therapy; Sepsis - metabolism; Thrombin - analysis; Thrombin - drug effects; Thrombin - metabolism; Tissue Plasminogen Activator - blood; Tissue Plasminogen Activator - drug effects; Tissue Plasminogen Activator - immunology; Tumor Necrosis Factor-alpha - immunology; Up-Regulation; Urokinase-Type Plasminogen Activator - blood; Urokinase-Type Plasminogen Activator - drug effects; Urokinase-Type Plasminogen Activator - immunology; von Willebrand Factor - analysis; von Willebrand Factor - drug effects; von Willebrand Factor - metabolism
• ISSN: 1073-2322
• DOI: 10.1097/00024382-199610000-00001

Tumor necrosis factor-alpha (TNF alpha) is a central mediator in the pathogenesis of sepsis. It also interferes with the hemostatic system and exerts and a net procoagulant effect. Since TNF alpha may contribute to thrombotic complications in sepsis patients, we determined markers of thrombin activation, parameters of the fibrinolytic system (D-dimer, tissue plasminogen activator antigen (tPA) urinary type plasminogen activator antigen (uPA), plasminogen activator inhibitor antigen (PAI-1) and von Willebrand factor antigen (vWF) in 30 patients with sepsis or septic shock. All patients were treated with standard therapy, but 14 patients were treated additionally with an anti-TNF alpha monoclonal antibody (MAK 195F); 16 patients served as historical controls. No significant effect of the antibody on the parameters of the hemostatic system could be determined. Our data speak against a modulation of coagulation or the fibrinolytic system by the monoclonal anti-TNF alpha antibody MAK 195F in this cohort of sepsis patients.