RGD Reference Report - Alveolar plasminogen activator inhibitor-1 predicts ARDS in aspiration pneumonitis. - Rat Genome Database

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Alveolar plasminogen activator inhibitor-1 predicts ARDS in aspiration pneumonitis.

Authors: El Solh, AA  Bhora, M  Pineda, L  Aquilina, A  Abbetessa, L  Berbary, E 
Citation: El Solh AA, etal., Intensive Care Med. 2006 Jan;32(1):110-5. Epub 2005 Nov 12.
RGD ID: 4144039
Pubmed: PMID:16284739   (View Abstract at PubMed)
DOI: DOI:10.1007/s00134-005-2847-2   (Journal Full-text)

OBJECTIVE: To test the hypothesis that alveolar plasminogen activator inhibitor-1 (PAI-1) can identify patients with witnessed aspiration at risk for progression to acute respiratory distress syndrome (ARDS). DESIGN: Prospective observational study. SETTING: Medical intensive care unit in a tertiary care center. PATIENTS: Fifty-one patients with witnessed aspiration who had a PaO2/FIO2<300 for a period no less than 4 h from admission. INTERVENTIONS: Alveolar fluid sampling was performed within 8 h of intubation via luminal suction of the distal airways using a 13-Fr catheter. Plasma levels were collected simultaneously by venipuncture. MEASUREMENTS AND RESULTS: Alveolar PAI-1 antigen levels were more than five times higher in those who progressed to ARDS than in those with uncomplicated aspiration pneumonitis (2687+/-1498 ng/ml vs. 587+/-535 ng/ml, respectively; p<0.001), while plasma levels of PAI-1 antigen were not significantly different between the two groups. The measured activity of PAI-1 antigen paralleled the levels observed in both media. A cut-off level of alveolar PAI-1 >1518 ng/ml was found to be 82.4% (56.6%-96.0%) sensitive and 97.1% (84.6%-99.5%) specific in predicting progression to ARDS. There was also a significant inverse relationship between elevation of PAI-1 antigen levels and the degree of lung injury as assessed by the days of unassisted ventilation (r2=0.37; p<0.001). CONCLUSIONS: Elevation of alveolar PAI-1 antigen levels postaspiration is the consequence of local rather than systemic activation of the fibrinolytic system. Measurement of alveolar PAI-1 antigen levels can be a useful clinical marker in predicting progression to ARDS after gastric aspiration.



RGD Manual Disease Annotations    Click to see Annotation Detail View

  
Object SymbolSpeciesTermQualifierEvidenceWithNotesSourceOriginal Reference(s)
SERPINE1Humanadult respiratory distress syndrome  IEP associated with Pneumonia more ...RGD 
Serpine1Ratadult respiratory distress syndrome  ISOSERPINE1 (Homo sapiens)associated with Pneumonia more ...RGD 
Serpine1Mouseadult respiratory distress syndrome  ISOSERPINE1 (Homo sapiens)associated with Pneumonia more ...RGD 

Objects Annotated

Genes (Rattus norvegicus)
Serpine1  (serpin family E member 1)

Genes (Mus musculus)
Serpine1  (serine (or cysteine) peptidase inhibitor, clade E, member 1)

Genes (Homo sapiens)
SERPINE1  (serpin family E member 1)


Additional Information