In:
British Journal of Surgery, Oxford University Press (OUP), Vol. 73, No. 1 ( 2005-12-08), p. 38-40
Abstract:
Fibronectin is a plasma opsonin which is depleted after major injury or surgery. The effect of major aortic surgery on plasma fibronectin has been studied in patients and in an equivalent experimental model in pigs. On the day after aortic surgery in eleven patients mean fibronectin (±s.e.m.) had fallen from 363 ± 11 mg/l pre-operatively to 179 ± 19 mg/l (P & lt; 0.01). No such fall was observed in patients undergoing herniorrhaphy. In fourteen pigs aortic surgery produced reproducible surgical shock and a fall in plasma fibronectin from 331 ± 10 mg/l to 43 ± 13 mg/l after resuscitation (P & lt; 0.01). Whenever plasma fibronectin fell below 190 mg/l the circulating free fibronectin was consumed in complexes of 1000 kDa containing collagenous debris. More severe depletion of plasma fibronectin was related to higher concentrations of circulating non-opsonized collagenous debris and to subsequent mortality in pigs. The depletion of free fibronectin that occurs following major surgery may produce clinically important opsonic dysfunction. The clinical relevance of this fibronectin consumption may be missed if measurement is limited to circulating fibronectin levels without determining that proportion bound in complexes and no longer available as an opsonin.
Type of Medium:
Online Resource
ISSN:
0007-1323
,
1365-2168
DOI:
10.1002/bjs.1800730114
Language:
English
Publisher:
Oxford University Press (OUP)
Publication Date:
2005
detail.hit.zdb_id:
2006309-X
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