Meta-Analysis of Preclinical Studies of Fibrinolytic Therapy for Acute Lung Injury.

ABSTRACT:

Background

Acute lung injury (ALI) is characterized by suppressed fibrinolytic activity in bronchoalveolar lavage fluid (BALF) attributed to elevated plasminogen activator inhibitor-1 (PAI-1). Restoring pulmonary fibrinolysis by delivering tissue-type plasminogen activator (tPA), urokinase plasminogen activator (uPA), and plasmin could be a promising approach.

Objectives

To systematically analyze the overall benefit of fibrinolytic therapy for ALI reported in preclinical studies.

Methods

We searched PubMed, Embase, Web of Science, and CNKI Chinese databases, and analyzed data retrieved from 22 studies for the beneficial effects of fibrinolytics on animal models of ALI.

Results

Both large and small animals were used with five routes for delivering tPA, uPA, and plasmin. Fibrinolytics significantly increased the fibrinolytic activity both in the plasma and BALF. Fibrin degradation products in BALF had a net increase of 408.41?ng/ml vs controls (P?P?=?0.0001). In sharp contrast, PAI-1 level in BALF decreased 21.44?ng/ml compared with controls (P?P?=?0.0001 vs controls). Additionally, fibrinolytics improved lung function and alleviated inflammation response: the lung wet/dry ratio was decreased 1.49 (P?P?4/ml, P?P?=?0.0008).

Conclusion

We conclude that fibrinolytic therapy may be effective pharmaceutic strategy for ALI in animal models.

SUBMITTER: Liu C 

PROVIDER: S-EPMC6110197 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature