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Erschienen in: Intensive Care Medicine 2/2008

01.02.2008 | Original

Association between urokinase haplotypes and outcome from infection-associated acute lung injury

verfasst von: John Arcaroli, Jeff Sankoff, Nianjun Liu, David B. Allison, James Maloney, Edward Abraham

Erschienen in: Intensive Care Medicine | Ausgabe 2/2008

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Abstract

Objective

Alterations in coagulation, including elevated pulmonary and systemic concentrations of urokinase, are frequent in patients with acute lung injury (ALI). Urokinase potentiates neutrophil activation and contributes to the severity of pulmonary injury in preclinical models of ALI. The objective of this study was to examine associations between polymorphisms and haplotypes of urokinase with risk for and outcomes from ALI.

Design

Prospective cohorts of healthy European-American adults and those with infection-associated ALI.

Setting

Academic medical centers participating in NIH funded studies of low tidal volume ventilation for ALI.

Patients

Controls were 175 healthy European-American subjects. Patients were 252 individuals with infection-associated ALI, prospectively followed for 60 days for mortality.

Interventions

Genetic polymorphisms and haplotypes in the urokinase gene were determined.

Measurements and main results

Six polymorphisms, rs1916341, rs2227562, rs2227564, rs2227566, rs2227571, and rs4065, defining 98% of all urokinase haplotypes, were analyzed. There were no statistically significant associations between any single urokinase polymorphism or haplotype and risk for developing ALI. In contrast, there was a statistically significant relationship between the CGCCCC haplotype and both 60-day mortality and ventilator-free days that remained present in a multivariate analysis controlling for age and sex (p = 0.033 for 60-day mortality and < 0.001 for ventilator-free days).

Conclusions

These results identify a specific urokinase haplotype as a genetic risk factor for higher mortality and more severe clinical outcome in patients with infection-associated ALI.
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Metadaten
Titel
Association between urokinase haplotypes and outcome from infection-associated acute lung injury
verfasst von
John Arcaroli
Jeff Sankoff
Nianjun Liu
David B. Allison
James Maloney
Edward Abraham
Publikationsdatum
01.02.2008
Verlag
Springer-Verlag
Erschienen in
Intensive Care Medicine / Ausgabe 2/2008
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-007-0930-6

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Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

23.04.2024 Operationsvorbereitung Nachrichten

Derzeit wird empfohlen, eine Therapie mit GLP-1-Rezeptoragonisten präoperativ zu unterbrechen. Eine neue Studie nährt jedoch Zweifel an der Notwendigkeit der Maßnahme.

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