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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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          Abstract

          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.
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            Author and article information

            Journal
            BPU
            Blood Purif
            10.1159/issn.0253-5068
            Blood Purification
            S. Karger AG
            0253-5068
            1421-9735
            2000
            2000
            23 February 2000
            : 18
            : 1
            : 50-54
            Affiliations
            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
            Article
            14407 Blood Purif 2000;18:50–54
            10.1159/000014407
            10686442
            490fa7be-3e63-4470-9926-231026027567
            © 2000 S. Karger AG, Basel

            Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

            History
            Page count
            Tables: 4, References: 17, Pages: 5
            Categories
            Original Paper

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

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