Introduction: Effective resuscitation with human albumin solutions is achieved with less fluid than with crystalloid solutions. However, the role of albumin in today’s critical care unit is also linked to its multiple pharmacological effects.
Areas covered: The potential clinical benefits of albumin in select populations of critically ill patients like sepsis seem related to immunomodulatory and anti-inflammatory effects, antibiotic transportation and endothelial stabilization. Albumin transports many drugs used in critically ill patients. Such binding to albumin is frequently lessened in critically ill patients with hypoalbuminemia. These changes could result in sub-optimal treatment. Albumin has immunomodulatory capacity by binding several bacterial products. Albumin also influences vascular integrity, contributing to the maintenance of the normal capillary permeability. Moreover, the albumin molecule encompasses several antioxidant properties, thereby significantly reducing re-oxygenation injury, which is especially important in sepsis. In fact, most studies of albumin administration are a combination of a degree of resuscitation with a degree of maintenance or supplementation of albumin.
Expert commentary: The potential clinical benefits of the use of albumin in selected critically ill patients such as sepsis seem related to its immunomodulatory and anti-inflammatory effects, antioxidant properties, antibiotic transportation and endothelial stabilization. Additional studies are warranted to further elucidate the underlying physiologic and molecular rationale. 相似文献
KR 31372 is a benzopyran derivative. Both [3H]thymidine incorporation and migrations (chemotactic and wound-edge) of cultured smooth muscle cells (SMCs) were greatly stimulated by oxidized low-density lipoprotein (LDL). These effects were significantly suppressed by KR 31372 (10(7) - 10(6) M) and PDGF-BB antibody (10(8) - 10(6) M). Preincubation with KR 31372 led to a decrease in the synthesis of PDGF-BB-like immunoreactivity (PDGF-BB-LI) that had been stimulated by oxidized LDL. Otherwise, KR 31372 and probucol strongly inhibited the production of thiobarbituric acid reactive substances (TBARS) caused by the incubation of LDL with Cu2+ ion, and significantly reduced the intracellular oxidative stress when stimulated with H,O2. Taken together, it is suggested that KR 31372 may inhibit the oxidized LDL-stimulated syntheses of DNA and PDGF-BB, and migration of the SMCs, in part, via the antioxidant activity. 相似文献