Is tri-iodothyronine a better choice than activated protein C in sepsis treatment?

BACKGROUND: Sepsis can be defined as a life-threatening organ dysfunction due to a dysregulated host response to infection. In sepsis, the coagulation cascade is activated and the balance shifts to the procoagulant side. Recently, the use of protein C is proposed for the treatment of sepsis. Another therapeutic agent that has been intensively studied is tri-iodothyronine.
METHODS: This study aimed to compare the effects of activated protein C and tri-iodothyronine, which are administered at a single dose to sepsis-induced rats at the late phase. Leukocyte, platelet, hemoglobin and antithrombin-III concentrations and histopathological changes in the small intestine, liver and lung were evaluated at 24 hours.
RESULTS: Single-dose intraperitoneal recombinant human APC (activated protein C) has a partial curative effect on hematological parameters in the late phase, while it is possible to state that it has significant therapeutic effects on hepatic and intestinal tissues, but more remarkably on the lung tissue. Tri-iodothyronine is also considered to be used for the treatment and has a strong potential to be a therapeutic agent.
CONCLUSION: We observed that the T3 hormone has significantly limited and reduced the sepsis-related damage to hepatic and intestinal tissues, but especially the lung tissue. Tri-iodothyronine can be a good alternative to APC, which is partially allowed due to high cost and complication of bleeding in the treatment of sepsis.

Sepsis tedavisinde triiyodotironin aktive protein C’ye göre daha iyi bir seçenek midir?

AMAÇ: Sepsis, enfeksiyona karþý konaðýn göstermiþ olduðu disregüle yanýta baðlý geliþen hayatý tehdit edici bir organ disfonksiyonu olarak tanýmlanabilir. Sepsiste, koagülasyon kaskatý aktive olur ve denge prokoagülan tarafa doðru kayar. Protein C’nin sepsis tedavisinde kullanýmýný araþtýran yakýn tarihli çalýþmalar mevcuttur. Ayrýca diðer bir terapötik ajan olan triiyodotironin hakkýnda da çalýþmalar yapýlmýþtýr.
GEREÇ VE YÖNTEM: Çalýþmamýzda sepsis oluþturulmuþ sýçanlarda geç dönemde tek doz aktive protein C ve triiyodotironin uygulamasýnýn etkileri karþýlaþtýrýldý. Uygulama sonrasý 24. saatte lökosit, platelet, hemoglobin ve antitrombin-III konsantrasyonlarý ile ince baðýrsak, karaciðer ve akciðerdeki histopatolojik deðiþiklikler deðerlendirildi.
BULGULAR: Intraperitoneal tek doz rekombinant insan APC (aktive protein C) uygulamasýnýn geç fazda hematolojik parametrelerde küratif etkileri olduðu ve baþta akciðer olmak üzere hepatik ve ince barsak dokusunda da anlamlý terapötik etkilerinin olabileceði görülmüþtür. Triiyodotironin ise sepsis tedaivisnde kullanýlabilecek önemli bir terapötik ajan olarak deðerlendirildi.
TARTIÞMA: Çalýþmamýzda T3 hormonunun özellikle akciðer dokusu olmak üzerre karaciðer ve ince baðýrsak dokusu üzerinde sepsis baðlý hasarý sýnýrladýðý veya azalttýðý gözlenmiþtir. Triiyodotironin daha az maliyet ve kanama riskiyle sepsis tedavisinde APC’ye iyi bir alternatif olabileceði kanaatinedeyiz.