Recombinant activated protein C in sepsis: endothelium protection or endothelium therapy?

摘要: Endothelium dysfunction is one of the hallmarks sepsis. Looney and Mattay, in previous issue Critical Care, highlight role activated protein C (APC) as a protective endothelial drug septic situations. Nevertheless, results vivo studies are less explicit it remains uncertain whether these properties relevant human shock. Before considering recombinant APC (rAPC) therapeutic for endothelium, we have to demonstrate its efficiency protect or reduce endothelium injury when infused long time after challenge. if rAPC efficient early phase challenge, thus need treat our patients earlier. At least, genetically engineered variants been designed with greater anti-apoptotic activity reduced anticoagulant relative wild-type APC. Further needed usefulness shock therapy.