Introduction
Materials and methods
Animals
Anticoagulant strategies
Measurements
Lung histopathology
In vitro studies on the antimicrobial effects of plasma-derived AT
Statistical analysis
Results
Pneumonia
Pulmonary coagulation and fibrinolysis
Systemic coagulation and fibrinolysis
Bacterial outgrowth from lungs
Inflammatory response
Total cells | Neutrophils | MPO | |
---|---|---|---|
Controls
| 21 (19-24) | 0 (0-0) | 32 (20-59) |
Streptococcus pneumoniae
pneumonia (t = 40 hours)
| |||
Placebo | 171 (92-206) | 73 (39-112) | 99 (53-106) |
rh-aPC | 208 (122-233) | 86 (56-104) | 186 (66-265) |
AT | 36 (23-38)* | 1 (0-5)** | 68 (24-74) |
Heparin | 417 (313-579) | 92 (69-114) | 498 (224-932)* |
Danaparoid | 542 (462-681) | 111 (99-125) | 407 (167-535) |
Histopathology
Outgrowth of S. pneumoniae in BALF: effect of plasma-derived AT
Discussion
Lung-protective effects of plasma-derived AT
Systemic anticoagulant affects of nebulized anticoagulants
Previous studies on anticoagulant strategies for pneumonia
In vitro experiments
Limitations
Conclusions
Key messages
-
In experimental pneumococcal pneumonia in rats nebulizing anticoagulants attenuates pulmonary coagulopathy allowing a higher local dose, while reducing systemic effects.
-
AT has significant lung-protective effect which seems to be related, at least in part, to an indirect role in reduction of bacterial outgrowth of S. pneumoniae.
-
More research is required to evaluate the safety and efficacy of nebulized anticoagulants in patients.