Opsonic dysfunction secondary to plasma fibronectin depletion after aortic surgery. 1986

J T Powell, and K R Poskitt, and J T Irwin, and R L Attanoos, and C N McCollum

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 less than 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 less than 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 nonopsonized 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.

UI MeSH Term Description Entries
D009895 Opsonin Proteins Proteins that bind to particles and cells to increase susceptibility to PHAGOCYTOSIS, especially ANTIBODIES bound to EPITOPES that attach to FC RECEPTORS. COMPLEMENT C3B may also participate. Opsonin,Opsonin Protein,Opsonins,Protein, Opsonin
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D005353 Fibronectins Glycoproteins found on the surfaces of cells, particularly in fibrillar structures. The proteins are lost or reduced when these cells undergo viral or chemical transformation. They are highly susceptible to proteolysis and are substrates for activated blood coagulation factor VIII. The forms present in plasma are called cold-insoluble globulins. Cold-Insoluble Globulins,LETS Proteins,Fibronectin,Opsonic Glycoprotein,Opsonic alpha(2)SB Glycoprotein,alpha 2-Surface Binding Glycoprotein,Cold Insoluble Globulins,Globulins, Cold-Insoluble,Glycoprotein, Opsonic,Proteins, LETS,alpha 2 Surface Binding Glycoprotein
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D001014 Aortic Aneurysm An abnormal balloon- or sac-like dilatation in the wall of AORTA. Aneurysm, Aortic,Aneurysms, Aortic,Aortic Aneurysms
D001018 Aortic Diseases Pathological processes involving any part of the AORTA. Aortic Disease,Disease, Aortic,Diseases, Aortic
D012773 Shock, Surgical A type of shock that occurs as a result of a surgical procedure. Surgical Shock,Surgical Shocks
D013552 Swine Any of various animals that constitute the family Suidae and comprise stout-bodied, short-legged omnivorous mammals with thick skin, usually covered with coarse bristles, a rather long mobile snout, and small tail. Included are the genera Babyrousa, Phacochoerus (wart hogs), and Sus, the latter containing the domestic pig (see SUS SCROFA). Phacochoerus,Pigs,Suidae,Warthogs,Wart Hogs,Hog, Wart,Hogs, Wart,Wart Hog

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