Skip to main content
SpringerLink
Log in

The Role of Proteolytic Enzyme Systems with Particular Emphasis on the Plasma Kallikrein-Kinin System During Septicemia and Septic Shock

  • Conference paper
Septic Shock

Part of the book series: Update in Intensive Care and Emergency Medicine ((UICM,volume 4))

Abstract

Both in endotoxin shock in experimental animals and during septicemia in man pronounced proteolytic activity of plasma has been observed. Proteolytic involvement in this state due to activation of the coagulation and the fibrinolytic system was detected many years ago [1, 2]. Some early studies also suggested that the kallikrein-kinin system might be of significance for the pathophysiological changes seen [3, 4]. Clinical studies performed during the seventies provided more solid data which put particular emphasis on activation of the kallikreinkinin and complement systems for the development of shock and death during endotoxemia [5–7]. In a study on soldiers wounded in battle during the Vietnamese war, it was observed that blood samples obtained from those who died of gram-negative septicemia had very low contents of high molecular weight kininogen [7]. In the patients surviving gram-negative septicemia, the blood kininogen levels, after an initial lowering, rose towards normal values.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. McKay DG, Wahle GH Jr (1955) Epidemic gastroenteritis due to Escherichia coli 0111B4. Arch. Pathol 60: 679–696

    CAS  Google Scholar 

  2. Rapaport SI, Tatter D, Coer-Barron N, Hjort PF (1964) Pseudomonas septicemia with intravascular clotting leading to the generalized Shwartzman reaction. N Engl J Med 271: 80–84

    Article  PubMed  CAS  Google Scholar 

  3. Diniz CR, Carvalho IE (1963) A micromethod for determination of bradykinin under several condition. Ann N Y Acad Sci 104: 77–89

    Article  PubMed  CAS  Google Scholar 

  4. Kobold EE, Lovell R, Katz W, Thal AP (1964) Chemical mediators released by endotoxin. Surg Gynecol Obstet 118: 807–813

    PubMed  CAS  Google Scholar 

  5. Mason JW, Kleeberg U, Dolan P, Colman RW (1970) Plasma kallikrein and Hageman factor in gram-negative bacteremia. Ann Intern Med 73: 545–551

    PubMed  CAS  Google Scholar 

  6. McCabe WR (1973) Serum complement levels in bacteremia due to gram-negative organisms. N Engl J Med 288: 21–23

    Article  PubMed  CAS  Google Scholar 

  7. Hirsch EF, Nakajima T, Ishima G, Erdös EG, Herman CM (1974) Kinin system responses in sepsis after trauma in man. J Surg Res 17: 147–153

    Article  PubMed  CAS  Google Scholar 

  8. Erdös EG (1976) The kinins. A status report. Biochem Pharmacol 25: 1563–1569

    Article  PubMed  Google Scholar 

  9. McConn R, Wasserman F, Haberland G (1982) The kallikrein kinin system in the acutely ill: Changes in plasma kininogen in acutely ill patients and the efficacy of pulmonary clearance of bradykinin. In: McConn (ed) Role of chemical mediators in the pathophysiology of acute illness and injury. Raven Press, New York, pp 111–126

    Google Scholar 

  10. Schapira M, Scott CF, Colman RM (1982) Contribution of plasma protease inhibitors to the inactivation of kallikrein in plasma. J Clin Invest 69: 462–467

    Article  PubMed  CAS  Google Scholar 

  11. Cochrane GG, Griffin JH (1982) The biochemistry and pathophysiology of the contact system of plasma. In: Kunkel HG, Dixon FJ (eds) Adv in Immunol. Vol 33. Academic press, New York, pp 241–306

    Google Scholar 

  12. Haverkate F, Brakman P (1975) Fibrin plate assay. In: Davidson JF, Samama MM, Des-Noyers PD (eds) Progress in chemical fibrinolysis and thrombolysis, Vol 1. Raven Press, New York, pp 151–159

    Google Scholar 

  13. Lachmann PJ, Hobart MJ, Aston WP (1973) Complement technology. In: Weir DM (ed) Handbook of Experimental Immunology, 2nd ed. Blackwell Scientific Publications, London

    Google Scholar 

  14. Schachter M (1969) Kallikreins and kinins. Physiol Rev 49: 509–547

    PubMed  CAS  Google Scholar 

  15. Surovikina MS (1975) Components of the plasma kinin system in rabbits with acute inflammation. Bull Exp Biol Med 80: 41–43

    Article  CAS  Google Scholar 

  16. Svendsen L, Blombäck M, Olsson PI (1972) Synthetic chromogenic substrates for determination of trypsin, thrombin and thrombin-like enzymes. Thromb Res 1: 267–278

    Article  CAS  Google Scholar 

  17. Abilgaard U, Lie M, Qdegârd OR (1976) A simple amidolytic method for the determination of functionally active antithrombin III. Scand J Clin Lab Invest 36: 109–112

    Article  Google Scholar 

  18. Amundsen E, Svendsen L, Vennerod AM, Laake K (1977) Determination of plasma kallikrein with a new chromogenic tripeptide derivative. Pisano JJ, Austen KF (eds) Chemistry and biology of the kallikrein-kinin system in health and disease. Fogarty International Center Prodeedings, No. 27, Washington, D.C. U.S. Government Printing Office, pp 215–220

    Google Scholar 

  19. Aasen AO, Kierulf P, Stremme J (1982) Methodological considerations on chromogenic peptide substrate assays and application on automated analyzer. Acta Chir Scand Suppl 509: 17–22

    PubMed  CAS  Google Scholar 

  20. Friberger P (1982) Chromogenic peptide substrates. Their use for the assay of factors in the fibrinolytic and the kallikrein-kinin system. Scand J Clin Lab Invest 42 (suppl): 162

    Google Scholar 

  21. Thal AP, Brown EB, Hermreck AS, Bell HH (1971) Shock. A physiological basis for treatment. Year book medical publishers, INC. Chicago

    Google Scholar 

  22. Shatney CH, Lillehei RC (1978) Septic shock associated with operation for colorectal disease. Dis Colon Rectum 27: 480–486

    Article  Google Scholar 

  23. Aasen AO, Smith-Erichsen N, Gallimore MJ, Amundsen E (1980) Studies on the components of the plasma kallikrein-kinin systems in plasma samples from normal individuals and patients with septic shock. Advances in Shock Research. Liss. Inc, New York, vol IV, pp 1–10

    Google Scholar 

  24. Fritz H (1980) Proteinase inhibitors in severe inflammatory processes (septic shock and experimental endotoxemia): Biochemical, pathophysiological and therapeutic aspects. In: Protein degradation in health and disease. Ciba Foundation Symp. 75 ( New Series). Excerpta Medica, Amsterdam, pp 351–379

    Google Scholar 

  25. Smith Erichsen N, Aasen AO, Amundsen E (1982) Treatment of sepsis in the surgical patient evaluted by means of chromogenic peptide substrate assays. Acta Chir Scand 509: 33–38

    Article  Google Scholar 

  26. Kalter ES, Timmermanns A, Bouma BN (1982) The kinin generating system during sepsis and bacterial shock. Agents Actions 9: 638–644

    Google Scholar 

  27. Aasen AO, Smith-Erichsen N, Amundsen E (1983) Plasma kallikrein-kinin system in septicemia. Arch Surg 118: 343–346

    PubMed  CAS  Google Scholar 

  28. Kalter ES, Daha MR, ten Lab JN, Verhoef J, Bouma BN (1985) Activation and inhibition of Hageman factor-dependent pathways and the complement system in uncomplicated bacteremia or bacterial shock. J Infect Dis 151: 1019–1027

    Article  PubMed  CAS  Google Scholar 

  29. Ohlsson K, Olsson I (1974) Neutral proteases of human granulocytes III. Interactions between human granulocyte elestase and plasma protease inhibitors. Scand J Clin Lab Invest 34: 349–355

    Article  PubMed  CAS  Google Scholar 

  30. Egbring R, Smidt W, Fuchs G, Habemann K (1977) Demonstration of granulocyte pro-teases in plasma of patients with acute leukemia and septicemia with coagulation defects. Blood 49: 219–231

    PubMed  CAS  Google Scholar 

  31. Fritz H, Jochum M, Duswald K-H, Dittmer H, Kortmann H, Neumann S, Lang H (1984) Granulocyte proteinases as mediators of unspecific proteolysis in inflammation. A review. In: Goldberg DM, Werner M (eds) Selected Topics in Clinical Enzymology, Vol 2. de Gruyter, Berlin, pp 305–328

    Google Scholar 

  32. Duswald K-H, Jochum M, Schramm W, Fritz H (1985) Release of granulocytic elastase: An indicator of pathobiochemical alterations in septicemia after abdominal surgery. Surgery 98: 892–899

    PubMed  CAS  Google Scholar 

  33. Sprung CL, Schultz DR, Marcial E, Charlis PV, Gelbard MA, Arnold PI, Long WM (1986) Complement activation in septic shock patients. Crit Care Med 14: 525–528

    Article  PubMed  CAS  Google Scholar 

  34. Gallimore MJ, Aasen AO, Smith-Erichsen N, Lassbraaten M, Lyngaas K, Amundsen E (1980) Plasminogen concentrations and functional activities and concentrations of plasmin inhibitors in plasma samples from normal subjects and patients with septic shock. Thromb Res 18: 601–608

    Article  PubMed  CAS  Google Scholar 

  35. ten Cate JW (1982) Antithrombin-III: Clinical significance. Acta Chir Scand 509: 101–105

    Google Scholar 

  36. Scipper HG, Roos J, van der Meulen F, ten Cate JW (1981) Antithrombin III deficiency in surgical intensive care patients. Thromb Res 21: 73–80

    Article  Google Scholar 

  37. Buller HR, Bolwerk C, ten Cate J, Roos J, Kahlé LH, ten Cate JW (1982) Postoperative hemostatic profile in relation to gram-negative septicemia. Critical Care Med 10: 311–315

    Article  CAS  Google Scholar 

  38. Witte J, Jochum M, Scherer R, Schramm W, Hochstrasser K, Fritz H (1982) Distribution of selected plasma proteins in hyperdynamic septic shock. Intensive Care Med 8: 215–222

    Article  PubMed  CAS  Google Scholar 

  39. Lämmle B, Tran TH, Ritz R, Duckett F (1984) Plasma prekallikrein, F XII, Antithrombin III, Cl-inhibitor and α2-macroglobulin in critically ill patients with suspected disseminated intravascular coagulation ( DIC ). Am J Clin Pathol 82: 396–404

    PubMed  Google Scholar 

  40. Aasen AO (1983) Evaluation of septic and severe traumatized patients by means of a new parameter. The proenzyme functional inhibition index. The Second Tore Nilson Symposium, Linköpin, Sweden, Sept 7–10

    Google Scholar 

  41. Aasen AO (1985) The proenzyme functional inhibition index. A new parameter for evaluation of the severely injured and septic patient. Acta Chir Scand Suppl 522: 211–233

    PubMed  CAS  Google Scholar 

  42. Smith-Erichsen N, Aasen AO (1984) Evaluation of severity and prognosis in early stages of septicemia by means of chromogenic peptide substrate assays. Eur Surg Res 2: 140–146

    Article  Google Scholar 

  43. Balldin G, Ohlsson K (1979) Demonstration of pancreatic protease-antiprotease complexes in the peritoneal fluid of patients with acute pancreatitis. Surgery 85: 451–456

    PubMed  CAS  Google Scholar 

  44. Lasson A (1984) Acute pancreatitis in man: A clinical and biochemical study of pathophysiology and treatment. Thesis, University of Lund. Scand J Gastro Enterol (Suppl) 99

    Google Scholar 

  45. Schipper HG, Kahle LH, Jenkins CSP, ten Cate JW (1978) Antithrombin III transfusion in disseminated intravascular coagulation. Lancet 2: 854–856

    Article  Google Scholar 

  46. van der Starre P, Sinclair D, Damen J (1980) Inhibition of the hypotensive effect of plasma protein solutions by C1-esterase inhibitor. J Thorac Cardiovasc Surg 79: 738–741

    PubMed  Google Scholar 

  47. Kalter ES, van Dijk WC, Timmermanns A, Verhoef J, Bouma BN (1983) Activation of purified human plasma prekallikrein triggered by cell wall fractions of Escherichia coli and Straphylococcus aureus. J Infect Dis 148: 682–691

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. A. O. Aasen
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Internal Medicine, Free University Hospital, De Boelelaan 1117, NL-1081 HV, Amsterdam, The Netherlands

    Jean Louis Vincent (Assistant-Director) & Lambertus G. Thijs (Assistant-Director) & 

Rights and permissions

Reprints and permissions

Copyright information

© 1987 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Aasen, A.O. (1987). The Role of Proteolytic Enzyme Systems with Particular Emphasis on the Plasma Kallikrein-Kinin System During Septicemia and Septic Shock. In: Vincent, J.L., Thijs, L.G. (eds) Septic Shock. Update in Intensive Care and Emergency Medicine, vol 4. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-83108-9_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-83108-9_10

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-17861-3

  • Online ISBN: 978-3-642-83108-9

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation