Why the study?
Are plasma levels of endothelin-1 (ET-1) associated with multiple organ failure and clinical outcomes in patients with disseminated intravascular coagulation?
Are plasma levels of endothelin-1 (ET-1) associated with multiple organ failure and clinical outcomes in patients with disseminated intravascular coagulation?
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Elevated endothelin-1 levels in DIC are associated with multiple organ failure and poor clinical improvement, suggesting a role in vasoconstriction and microcirculatory disorders.
We examined the changes in plasma levels of endothelin-1 (ET-1), a potent vasoconstrictor peptide, in 47 cases of disseminated intravascular coagulation (DIC) to investigate the role of ET-1 in DIC and its relation to multiple organ failure (MOF). A significant elevation of plasma levels of ET-1 was observed in some cases of DIC, especially in patients with sepsis, blastic crisis of chronic myelogenous leukemia, and cancer. However, no such significant elevation was observed in patients with acute promyelocytic leukemia (APL), acute leukemias except for APL, or non-Hodgkin lymphoma. Plasma levels of ET-1 were higher in patients with DIC with MOF than in those without MOF. Although the levels of ET-1 were decreased or remained low with clinical improvement in most DIC patients, the levels were further increased or remained high in patients who showed no improvement in DIC. It is suggested that ET-1 must play an important role in further progression of MOF with the vasoconstriction and microcirculatory disorders.
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Asakura et al. (1992) studied this question.
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