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      Effect of Plasma Exchange on Serum Tissue Inhibitor of Metalloproteinase 1 and Cytokine Concentrations in Patients with Fulminant Hepatitis


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          Aims: The present study assessed whether the serum concentrations of tissue inhibitor of metalloproteinase 1 (TIMP-1) and cytokines are altered in patients with fulminant hepatitis and whether plasma exchange affects these concentrations. Methods: Fifteen patients with fulminant hepatitis, 14 patients with severe acute hepatitis, and 20 healthy controls were included in this study. The serum levels of tumor necrosis factor alpha (TNF-α), interleukin 1β (IL-1β), interleukin 6 (IL-6), transforming growth factor beta (TGF-β), and TIMP-1 were determined in all patients upon hospital admission and before and after a single course of plasma exchange in the patients with fulminant hepatitis. Results: Ten out of the 15 patients with fulminant hepatitis and all patients with severe acute hepatitis survived. Serum TNF-α, IL-6, TGF-β, and TIMP-1 levels in patients with fulminant hepatitis were significantly higher than the levels in patients with severe acute hepatitis (p < 0.01). IL-1β was not detectable in either group. Plasma exchange reduced the increased serum concentrations of TNF-α, IL-6, TGF-β, and TIMP-1 in patients with fulminant hepatitis (p < 0.01). Conclusions: These data suggest that increased serum levels of TIMP-1 and cytokines may reflect severe hepatic inflammation and that plasma exchange is an effective therapy to reduce these levels.

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          Rapid one-step sandwich enzyme immunoassay for tissue inhibitor of metalloproteinases. An application for rheumatoid arthritis serum and plasma.

          A 1 h, one-step sandwich enzyme immunoassay was set up with a pair of monoclonal antibodies prepared against bovine tissue inhibitor of metalloproteinases (TIMP). TIMP in samples was allowed to react simultaneously with both solid-phase antibody and peroxidase-labeled Fab' of another antibody. Minimum sensitivity was 1 pg/well for bovine TIMP and 1.5 pg/well for human TIMP. The TIMP level in the sera of 38 rheumatoid arthritis (RA) patients (241 +/- 53 ng/ml, mean +/- SD) was significantly higher (P less than 0.001) than the level in the sera of 81 healthy subjects (175 +/- 39). A similar significant difference (P less than 0.001) was observed between the TIMP level in platelet-poor plasma of normal subjects (64 +/- 10) and that of RA patients (84 +/- 23), suggesting that the increase in TIMP seen in RA sera can not be ascribed merely to an increase in platelet-derived TIMP.

            Author and article information

            Blood Purif
            Blood Purification
            S. Karger AG
            23 February 2000
            : 18
            : 1
            : 50-54
            aDepartment of Medicine, Misato Junshin Hospital, Saitama, bDepartment of Medicine, Koto Hospital, Tokyo, cRenal Unit, Ageo Central Hospital, Saitama and dRenal Unit, Nishishinjuku Clinic, Tokyo, Japan
            14407 Blood Purif 2000;18:50–54
            © 2000 S. Karger AG, Basel

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            Page count
            Tables: 4, References: 17, Pages: 5
            Self URI (application/pdf): https://www.karger.com/Article/Pdf/14407
            Self URI (text/html): https://www.karger.com/Article/FullText/14407
            Self URI (journal page): https://www.karger.com/SubjectArea/Nephrology
            Original Paper

            Cardiovascular Medicine,Nephrology
            Extracellular matrix,Hepatitis,Growth factor,Apheresis
            Cardiovascular Medicine, Nephrology
            Extracellular matrix, Hepatitis, Growth factor, Apheresis


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