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研究生:楊湘晨
研究生(外文):Hsiang-Chen Yang
論文名稱:膳食補充魚油對敗血症大白鼠血液凝集病變與器官損傷的效應
論文名稱(外文):Effects of fish oil supplementation on coagulopathy responses and organ injury in septic rats
指導教授:謝建正謝建正引用關係
指導教授(外文):Chien-Cheng Hsieh
學位類別:碩士
校院名稱:中國文化大學
系所名稱:生活應用科學研究所
學門:民生學門
學類:生活應用科學學類
論文種類:學術論文
論文出版年:2005
畢業學年度:93
語文別:中文
中文關鍵詞:魚油紅花籽油椰子油敗血症盲腸結紮穿孔手術瀰漫性血管內凝血反應器官損傷
外文關鍵詞:fish oilsafflower seed oilcoconut oilsepsiscecal ligation and puncture operationdisseminated intravascular coagulationorgan injury
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敗血症(sepsis)是加護病房病患死亡的主要原因之一,雖然急症照護醫學有長足的進步,但是敗血性休克病患的死亡率仍然居高不下,約有46%~82%。敗血性休克反應的症狀有發燒、低血壓、瀰漫性血管內凝血反應(disseminated intravascular coagulation, DIC)及器官損傷,這些損傷能夠造成多重器官衰竭(multiple organ failure, MOF)。DIC反應是敗血性休克的症狀之一,其特徵是凝血作用過度活化,造成纖維蛋白形成與沉積,病理研究證明因DIC反應而死亡的病患其組織血管內有纖維蛋白存在。此外,實驗亦證實有效抑制DIC反應,確能降低死亡率。因此預防或治療血液凝集病變反應是照護敗血症個體的重要課題之一。

近年來,有研究顯示補充魚油可降低高血脂症個體的血脂質含量,也可以抑制凝血反應,減少血栓產生,因此可以降低罹患心血管疾病的風險。此外,基礎與臨床研究均顯示以靜脈營養方式補充魚油乳化物,可降低敗血症個體的發炎反應。然而,目前尚無研究報告探討膳食補充魚油對敗血症個體血液凝集病變與器官功能喪失的效應,我們計畫探討這些問題。

實驗中,雄性SD(Sprague-Dawley)大白鼠經口補充生理食鹽水、魚油、紅花籽油及椰子油30天,劑量為每天4 ml/kg。補充30天後,將測量血液凝集參數,包括凝血酶原時間(prothrombin time, PT)、活化部份凝血酶時間(activated partial thromboplastin time, APTT)、纖維蛋白原(fibrinogen, FIB)及D-雙元體(d-dimer)含量。結果顯示補充生理食鹽水、魚油、紅花籽油大白鼠的血液凝集參數彼此間無差異。並且測量血清丙胺酸轉胺酶(alanine transaminase, ALT)、全膽紅素(total bilirubin, TBIL)以評估肝臟功能。測量血尿素氮(blood urea nitrogen, BUN)、肌酸酐(creatinine, CRE)以評估腎臟功能。血清生化值結果顯示各組實驗動物補充油脂後,肝臟與腎臟功能均維持正常。更進一步研究補充油脂對於經盲腸結紮穿孔(cecal ligation and puncture, CLP)手術造成敗血症的大白鼠的效應,結果顯示生理食鹽水補充組大白鼠接受CLP手術14~18小時後,產生明顯DIC反應徵象,包括凝血酶原時間(22.6 ± 1.6 vs. 42.4 ± 3.5秒,p<0.05)、活化部份凝血酶時間(52.6 ± 1.4 vs. 107.9 ± 10.2秒,p<0.05)均顯著延長,而且血漿纖維蛋白原含量降低(432.9 ± 44.9 vs. 231.2 ± 52.0 mg/dl,p<0.05)。在補充魚油與紅花籽油的敗血症大白鼠,並未出現明顯的DIC徵象。相反的,補充椰子油並未改善敗血症大白鼠的血液凝集病變。此外,補充生理食鹽水的敗血症大白鼠出現明顯的肝腎功能缺損,包括ALT(20.3 ± 2.2 vs. 74.1 ± 6.1 mg/dl,p<0.05)、TBIL(0.33 ± 0.02 vs. 1.13 ± 0.12 mg/dl,p<0.05),BUN(12.8 ± 0.5 vs. 50.6 ± 9.3 mg/dl,p<0.05)及CRE(0.59 ± 0.04 vs. 1.04 ± 0.18 mg/dl,p<0.05)均顯著上升。而補充魚油或紅花籽油均可顯著降低上述血清生化檢驗項目的數值。相反地,補充椰子油對敗血症大白鼠的肝腎功能並無保護作用。這些結果建議補充魚油或紅花籽油可以改善敗血症大白鼠肝腎功能,然而補充生理食鹽水或椰子油對敗血症大白鼠的肝腎功能沒有保護作用。總括而言,魚油或紅花籽油可改善敗血症大白鼠DIC反應和器官損傷。
Sepsis is one of the major causes of patients death in intensive care units. There are great improvements in critical care medicine, but the mortality of patients with septic shock responses is still high. The mortality rate is about 46%~82%. The septic shock responses including fever, hypotension, disseminated intravascular coagulation (DIC), and damage that can lead to multiple organ failure (MOF). DIC is a systemic syndrome of septic shock characterized by enhanced activation of coagulation with some intravascular fibrin formation and deposition. Pathologic studies have demonstrated the presence of intravascular fibrin in tissues of patients who had died from an illness associated with evidence of DIC. Furthermore, experimental studies have demonstrated that effective inhibition of DIC can indeed reduce mortality. Therefore, prevention or management of coagulopathy response is one of important issues of in critical care of septic subjects.

In recent years, there were several studies demonstrated fish oil supplement might reduce blood lipid content of hyperlipidemia individuals. Fish oil supplement also inhibited blood coagulation and thrombus formation, and then reduced the risk of cardio vascular diseases. Furthermore, both of basic and clinical studies revealed that total parenteral supplementation with fish oil emulsion may reduce the inflammatory responses of septic individuals. However, there is no study to investigate the effects of dietary fish oil supplement on coagulopathy response and organ dysfunction of septic individuals. We plan to investigate these problems.

In study, male SD (Sprague-Dawley) rats were orally supplemented with normal saline, fish oil, safflower seed oil or coconut oil for 30 days, at the dosage of 4 ml/kg body weight / day. In the end of supplementation, we measured coagulation parameters including prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and d-dimer level. Our results showed that there were no differences in coagulation parameters among saline, fish oil, safflower seed oil and coconut oil supplement groups. We also measured serum alanine transaminase (ALT) and total bilirubin (TBIL) levels for hepatic function evaluation, and blood urea nitrogen (BUN), creatinine (CRE) levels for renal function evaluation. Serum biochemistry data showed that hepatic and renal function of all experimental groups are normal in the end of oils supplementation. Further investigated the effects of oils supplement on rats with cecal ligation and puncture (CLP)-induced sepsis. The saline supplement rats receiving CLP operation produced significant signs of DIC responses at 14~18hrs after CLP, including increased PT (22.6 ± 1.6 vs. 42.4 ± 3.5 sec, p<0.05), APTT (37.4 ± 6.5 vs. 107.9 ± 10.2 sec, p<0.05), as well as decreased plasma fibrinogen content (432.9 ± 44.9 vs. 231.2 ± 52.0 mg/dl, p<0.05). The rats receving fish oil or safflower seed oil supplement for 30 days were without significant signs of DIC responses in septic rats. In contrast, coconut oil supplement did not reversed the coagulopathy responses in rats with CLP-induced sepsis. Moreover, the saline supplement rats receving CLP operation produced significant signs of hepatic and renal dysfunction, including increased ALT (20.3 ± 2.2 vs. 74.1 ± 6.1 mg/dl, p<0.05), TBIL (0.33 ± 0.02 vs. 1.13 ± 0.12 mg/dl, p<0.05), BUN (12.8 ± 0.5 vs. 50.6 ± 9.3 mg/dl, p<0.05), and CRE (0.59 ± 0.04 vs. 1.04 ± 0.18 mg/dl, p<0.05). Fish oil or safflower seed oil supplment reduced serum levels of ALT, TBIL, BUN and CRE in septic rats. In contrast, coconut oil supplement did not liver and kidney of septic rats. These results suggesting that fish oil or safflower seed oil supplement improve hepatic and renal functions of septic rats. In contrast, saline or coconut oil supplement did not offer protective effects on hepatic and renal functions in septic rats. In conclusion, fish oil or safflower seed oil supplement ameliorated DIC responses and organ injury in rats with sepsis.
                           頁次
中文摘要……………………………………………………………………… i
英文摘要……………………………………………………………………… iv
內容目錄……………………………………………………………………… vii
表目錄………………………………………………………………………… viii
圖目錄………………………………………………………………………… ix
第一章 前言 ………………………………………………………………… 1
第二章 文獻探討 …………………………………………………………… 3
一、敗血性休克反應的機制……………………………………………… 3
二、魚油的生理功能……………………………………………………… 8
三、補充魚油對敗血症個體的影響……………………………………… 11
第三章 材料與方法 ………………………………………………………… 13
一、實驗用儀器…………………………………………………………… 13
二、實驗材料……………………………………………………………… 14
(一)實驗藥品……………………………………………………… 14
(二)實驗用套件…………………………………………………… 14
三、實驗方法……………………………………………………………… 15
(一)實驗動物……………………………………………………… 15
(二)實驗分組及油脂補充方式…………………………………… 15
(三)盲腸結紮穿孔(cecal ligation and puncture, CLP)誘發
敗血症實驗動物模式………………………………………… 16
(四)頸動脈插管手術……………………………………………… 17
(五)測量血液凝集參數…………………………………………… 18
(六)肝臟及腎臟功能之評估……………………………………… 21
(七)統計分析……………………………………………………… 22
第四章 結果與討論 ……………………………………………………………23
一、結果………………………………………………………………………23
(一)正常飲食外補充三種油脂大白鼠體重增加的情形………… 23
(二)正常飲食外補充三種油脂對大白鼠血清生化值及凝血
參數的影響…………………………………………………… 24
(三)正常飲食外補充三種油脂對敗血症大白鼠血清生化值
與凝血參數的影響……………………………………………28
二、討論 ……………………………………………………………………36
(一)以CLP手術引發大白鼠敗血症後觀察結果……………………36
(二)補充三種油脂對大白鼠凝血參數和肝腎功能的影響 ………37
(三)補充魚油及紅花籽油能有效改善敗血症大白鼠血液凝集
病變及肝腎功能 ……………………………………………40
第五章 結論……………………………………………………………………45
參考文獻 ………………………………………………………………………60
附錄一 …………………………………………………………………………69
附錄二 …………………………………………………………………………70
        
1.王文憲。HARPER’S生物化學要論。合記圖書出版社。1991年。第154頁。

2.Abraham E, Wunderink R, Silverman H, Perl TM, Nasraway S, Levy H, Bone R, Wenzel RP, Balk R, Allred R. Efficacy and safety of monoclonal antibody to human tumor necrosis factor-alpha in patients with sepsis syndrome. J Am Med Assoc 1995;273:931-934.

3.Alberio L, Lammle B, Esmon CT. Protein C replacement in severe meningococcemia: rationale and clinical experience. Clin Infect Dis 2001;32:1338-1346.

4.Ayala A, Urbanich MA, Herdon CD, Chaudry IH. Is sepsis-induced apoptosis associated with macrophage dysfunction? J Trauma 1996;40:568-574.

5.Baker CC, Chaudry IH, Gaines HO, Baue AE. Evaluation of factors affecting mortalitary rate after sepsis in a murine cecal ligation and puncture model. Surgery 1983;94:331-335.

6.Baue AE. Multiple, progressive, or sequential systems failure: A syndrome of the 1970s. Arch Surg 1975;110:779-781.

7.Bauer KA, ten Cate H, Barzegar S, Spriggs DS, Sherman ML, Rosenberg RD. Tumor necrosis factor infusion have a procoagulant effect on the hemostatic mechanism of humans. Blood 1989;74:165-172.

8.Bolton CF. Sepsis and the systemic inflammatory response syndrome: Neuromuscular manifestations. Crit Care Med 1996;24:1408-1416.

9.Bone RC, Fisher CJ Jr., Clemmer TP, Slotman GJ, Metz CA, Ballk RA. Sepsis syndrome: a valid clinical entity. Crit Care Med 1989;17:389-393.

10.Borden CW, Hall WH. Fatal transfusion reactions from massive bacterial contamination of blood. N Engl J Med 1951;245:760-764.

11.Botham KM, Maldonado EN, Chico Y, Zheng X, Avella M, Ochoa B. The influence of chylomicron remnants on cholesteryl ester metabolism in cultured rat hepatocytes: comparison of the effects of particles enriched in n-3 or n-6 polyunsaturated fatty acids. Biochim Biophys Acta 2001;1534:96-109.

12.Breli I, Koch T, Heller A, Schlotzer E, Grunert A, van Ackern K, Neuhof H. Alteration of n-3 fatty acid composition in lung tissue after short-term infusion of fish oil emulsion attenuates inflammatory vascular reaction. Crit Care Med 1996;24:1893-1902.

13.Carey MJ, Rodgers GM. Disseminated intravascular coagulation: clinical and laboratory aspects. Am J Hematol. 1998;59:65-73.

14.Caroff M, Karibian D. Structure of bacterial lipopolysaccharides. Carbohydr Res 2003;338:2431–2447.

15.Chandler WL, Velan T. Secretion of tissue plasminogen activator and plasminogen activator inhibitor 1 during cardiopulmonary bypass. Thromb Res 2003;112:185-192.

16.Chao CY, Yeh SL, Lin MT, Chen WJ. Effects of parenteral infusion with fish-oil or safflower-oil emulsion on hepatic lipids, plasma amino acids, and inflammatory mediators in septic rats. Nutrition 2000;16:284-288.

17.Chaudry IH. Sepsis: lessons learned in the last century and future directions. Arch Surg 1999;134:922-929.

18.Chen HI, Hu CT, Wu CY, Wang D. Nitric oxide in systemic and pulmonary hypertension. J Biomed Sci 1997;4:244-248.

19.Chen HI, Hu CT. Endogenous nitric oxide on arterial hemodynamics: a comparison between normotensive and hypertensive rats. Am J Physiol 1997;273:H1816-H1823.

20.Clarke SD, Jump DB. Dietary polyunsaturated fat regulation of gene transcription. Annu Rev Nutr 1994;14:83-98.

21.Clarke SD, Turini M., Jump D. Polyunsaturated fatty acids regulate lipogenic and peroxisomal gene expression by independent mechanisms. Prostaglandins Leukot Essent Fatty Acids 1997;57:65-69.

22.Clifford CB, Giknis MLA. Clinical chemistry and hematology control values for crl: CD (SD) BR rats maintained on regimen of caloric restriction. Charles River Laboratories 1999;12-15.

23.Crawford JH, Yang S, Zhou M, Simms HH, Wang P. Down-regulation of hepatic CYP1A2 plays an important role in inflammatory responses in sepsis. Crit Care Med 2004;32:502-508.

24.Deitch EA. Animal model of sepsis and shock: a review and lessons learned. Shock 1998;9:1-11.

25.Dhainaut JF, Mira JP, Brunet F. Platelet activating factor antagonists as therapeutic strategy in sepsis. Prog Clin Biol Res 1994;388:277-279.

26.Dhainaut JF, Tenaillon A, Le Tulzo Y, Schlemmer B, Solet JP, Wolff M, Holzapfel L, Zeni F, Dreyfuss D, Mira JP. Platelet-activating factor receptor antagonist BN 52021 in the treatment of severe sepsis. Crit Care Med 1994;22:1720-1728.

27.Dhainaut JF, Yan SB, Margolis BD, Lorente JA, Russell JA, Freebairn RC, Spapen HD, Riess H, Basson B, Johnson G III, Kinasewitz GT; for the PROWESS Sepsis Study Group. Drotrecogin alfa (activated) (recombinant human activated protein C) reduces host coagulopathy response in patients with severe sepsis. Thromb Haemost 2003;90:642-653.

28.Dorfler M, Danner L, Shelhamer J, Parrillo J. Bacterial lipopolysaccharides priming human neutrophils for enhanced production of leukotriene B4. J Clin Invest 1989;83:970-977.

29.Dundley MN. Overview of gram-negative sepsis. Am J Hosp Pharm 1990;47:S3-S6.

30.Duplus E, Glorian M, Forest C. Fatty acid regulation of gene transcription. J Biol Chem 2000;275:30749-30752.

31.Dyerberg J, Bang HO, Stofferson E, Moncada S, Vane JR. Eicosapentaenoic acid and prevention of thrombosis and atherosclerosis. Lancet 1978;2:117-119.

32.Erdogan H, Fadillioglu E, Ozgocmen S, Sogut S, Ozyurt B, Akyol O,
Ardicoglu O. Effect of fish oil supplementation on plasma oxidant/antioxidant status in rats. Prostaglandins Leukot Essent Fatty Acids 2004;71:149-152.

33.Fisher CJ Jr., Opal SM, Lowry SF, Sadoff JC, LaBrecque JF, Donovan HC, Lookabaugh JL, Lemke J, Pribble JP, Stromatt SC. Role of interleukin-1 and the therapeutic potential of interleukin-1 receptor antagonist in sepsis. Circ Shock 1994;44:1-8.

34.Grimminger F, Fuhrer D, Papavassilis C, Schlotzer E, Mayer K, Heuer K, Kiss L, Walmrath D, Kramer HJ, Seeger W. Influence of intravenous n-3 lipid supplementation on fatty acids profiles and lipid mediator generation in patients with severe ulcerative colitis. Eur J Clin Invest 1993;23:706-715.

35.Groeneveld AB, Sipkema P. Interaction of oxyradicals, antioxidants, and nitric oxide during sepsis. Crit Care Med 2000;28:2161-2162.

36.Guthrie LA, McPhail LC, Henson PM, Johnston RB. Priming of neutrophils for enhanced release of oxygen metabolites by bacterial lipopolysaccharides. J Exp Med 1984;160:1656-1671.

37.Harris WS. Fish oils and plasma lipid and lipoprotein metabolism in humans:a critical review. J Lipid Res 1989;30:785-807.

38.Hooper WC, Phillips DJ, Renshaw MA, Evatt BL, Benson JM. The up-regulation of IL-6 and IL-8 in human endothelial cells by activated
protein C. J Immunol 1998;161:2567-2573.

39.Hwang D. Modulation of the expression of cyclooxygenase 2 by fatty acids mediated through toll-like receptor 4-derived signaling pathways. FASEB J 2001;15:2556-2564.

40.Jacobi J. Sepsis: a frequent, life-threatening syndrome. Pharmacotherapy 2002;22:169S-181S.

41.Johnson ML, Billiar TR. Roles of nitric oxide in surgical infection and sepsis. World J Surg 1998;22:187-196.

42.Joyce DE, Nelson DR, Grinnell BW. Leukocyte and endothelial cell interactions in sepsis:Relevance of the protein C pathway. Cirt Care Med 2004;32:S280-S286.

43.Jump DB. The biochemistry of n-3 polyunsaturated fatty acids. J Biol Chem 2002;277:8755-8758.

44.Kim DN, Schmee J, Lee CS, Solis O, Ross JS, Thomas WA. Reductions in serum thromboxane, prostacyclin, and leukotriene B4 levels in swine fed a fish oil supplement to an atherogenic diet. Exp Mol Pathol 1991;55:1-12.

45.Kinsella JE. Food components with potential therapeutic benefits: The n-3 polyunsaturated fatty acids of fish oils. Food Technol 1986;40:89-97.

46.Kirkeboen KA, Strand OA. The role of nitric oxide in sepsis-an overview. Acta Anaesthesiol Scand 1999;43:275-288.

47.Kishimoto TK, Jutila MA, Berg EL, Butcher EC. Neutrophil Mac-1 and Mel-14 adhesion proteins inversely regulated by chemotactic factors. Science 1989;245:1238-1241.

48.Lanza-Jacoby S, Flynn JT, Miller S. Parenteral supplementation with a fish-oil emulsion prolongs survival and improves rat lymphocyte function during sepsis. Nutrition 2001;17:112-116.

49.Lanza-lacoby S, Phetteplace H, Tripp R. Enteral feeding a structured lipid emulsion containing fish oil prevents the fatty liver of sepsis. Lipids 1995;30:707-712.

50.McIntosh GH, McLennan PL, Lawson CA, Bulman FH, Charnock JS. The influence of dietary fats on plasma lipids, blood pressure and coagulation indices in the rat. Atherosclerosis 1985;55:125-34.

51.Mesters RM, Florke N, Ostermann H, Kienast J. Increase of plasminogen activator inhibitor levels predicts outcome of leukocytopenic patients with sepsis. Thromb Haemost 1996;75:902-907.

52.Miller GJ. Dietary fatty acids and the haemostatic system. Atherosclerosis 2005;179:213-227.

53.Moore KL, Andreoli SP, Esmon NL, Bang NU. Endotoxin enhances tissue factor and suppresses thrombomodulin expression of human vascular endothelium in vitro. J Clin Invest 1987;79:124-130.

54.Moore KL, Emmon CT, Emmon NL. Tumor necrosis factor leads to the internalization and degradation of thrombomodulin from the surface of bovine aortic endothelial cells in culture. Blood 1989;73:159-165.

55.Nawroth PP, Stern DM. Modulation of endothelial cell hemostatic properties by tumor necrosis factor. J Exp Med 1986;163:740-745.

56.Neumann FJ, Ott I, Marx N, Luther T, Kenngott S, Gawaz M, Kotzsch M, Schomig A. Effect of human recombinant interleukin-6 and interleukin-8 on monocyte procoagulant activity. Arterioscler Thromb Vasc Biol 1997;17:3399-3405.

57.Ntambi JM. Regulation of stearoyl-CoA desaturase by polyunsaturated fatty acids and cholesterol. J Lipid Res 1999;40:1549-1558.

58.Okajima K, Uchiba M. The anti-inflammatory properties of antithrombin III-new therapeutic implications. Semin Thromb Hemost 1998;24:27-32.

59.Parrillo JE. Pathogenetic mechanisms of septic shock. N Engl J Med 1993;20:1471-1477.

60.Perkash I, Satpati P, Agawal KC, Chakravarti RN, Chhuttani PN. Prolonged peritoneal lavage and fecal peritonitis. Surgery 1970;68:842-845.

61.Pernerstorfer T, Hollenstein U, Hansen JB, Knechtelsdorfer M, Stohlawetz P, Graninger W, Eichler HG, Speiser W, Jilma B. Heparin blunts endotoxin-induced coagulation activation. Circulation 1999;100:2485-2490.

62.Peter P. The immune system. Garland Publishing, London. 2000:201-219.

63.Plantinga EA, Beynen AC. The influence of dietary fish oil vs. sunflower oil on the fatty acid composition of plasma cholesteryl-esters in healthy, adult cats. J Anim Physiol Anim Nutr 2003;87:373-379.

64.Pohlman T, Stannes K, Beatty P, Ochs H, Harian J. An endothelial cell surface factor(s) induced in vitro by lipopolysaccharides, interleukin-1, and tumor necrosis factor increases neutrophil adherence by CDW18-dependent mechanism. J Immunol 1986;136:458-464.

65.Pober JS, Cotran RS. Cytokines and endothelial cell biology. Physiol Rev 1990;70:427-451.

66.Remick DG, Freay AD, Kauser K, Sukovich D, Burton G, Lubahn DB, Couse JF, Curtis SW, Korach KS. Vascular estrogen receptors and endothelium-derived nitric oxide production in the mouse aorta. Gender difference and effects of estrogen receptor gene disruption. J Clin Invest 2000;99:2429-2437.

67.Ren B, Annette PT, Jeffrey MP, Frank JG, Donald BJ. Polyunsaturated fatty acid suppression of hepatic fatty acid synthase and S14 gene expression does not require peroxisome proliferator-activated receptor α. J Biol Chem 1997;272:26827-26832.

68.Rivers RP, Hathaway WE, Weston WL. The endotoxin-induced coagulant activity of human monocytes. Br J Haematol 1975;30:311-316

69.Rixen D, Siegel JH, Espina N, Bertolini M. Plasma nitric oxide in posttrauma critical illness: a function of sepsis and the physiologic state severity classification quantifying the probability of death. Shock 1997;7:17-28.

70.Root PK, Jacobs R. Septicemia and septic shock. In: Wilson JD, Braunwald E, Isselbacher JK, eds. Harrison’s Principles of Internal Medicine, 12th ed. New York, McGraw-Hill, 1991;502-507.

71.Samuelsson B. From studies of biochemical mechanism to novel biological mediators: prostaglandin endoperoxides, thromboxanes, and leukotrienes. Biosci Rep 1983;3:791-813.

72.Sandset PM, Abildgaard U, Larsen ML. Heparin induces release of extrinsic coagulation pathway inhibitor(EPI). Thromb Res 1988;50:803-813.

73.Schleef RR, Bevilacqua MP, Sawdey M, Gimbrone MA Jr, Loskutoff DJ. Cytokine activation of vascular endothelium: effects on tissue-type plasminogen activator and type 1 plasminogen activator inhibitor. J Biol Chem. 1988;263:5797-5803.

74.Sethi S, Ziouzenkova O, Ni H, Wagner DD, Plutzky J, Mayadas TN. Oxidized omega-3 fatty acids in fish oil inhibit leukocyte-endothelial interactions through activation of PPARα. Blood 2002;100:1340-1346.

75.Szabo C, Mitchell JA, Thiemermann C, Vane JR. Nitric oxide-mediated hyporeactivity to noradrenaline precedes the induction of nitric oxide synthase in endotoxin shock. Br J Pharmacol 1993;108:786-792.

76.Takahashi M, Tsuboyama N, Nakatani T, Ishii M, Tsutsumi S, Aburatani H, Ezaki O. Fish oil feeding alters liver gene expressions to defend against PPARalpha activation and ROS production. Am J Physiol 2002;282:G338-G348.

77.Taylor DE, Piantadosi CA. Oxidative metabolism in sepsis and sepsis syndrome. J Crit Care 1995;3:122-135.

78.Van Dam-Mieras MCE, Muller AD, Hemker HC. Proenzymes, enzymes, inhibitors, cofactor. In: Bergmeyer HU, Bergmeyer J, Grassl M eds. Methods of Enzymatic Analysis, Volume V. Weinheim, Germany: VCH Publishers; 1988:352-365.

79.Van der Poll T. Cytokines and their inhibition in septicaemia: the role of three major cytokines in pathogenesis of septicaemia. Br J Int Care 1992;2:99-112.

80.Van der Poll T, Levi M, Hack CE, ten Cate U, van Deventer SJH, Eerenberg AJ, de Groot ER, Jansen J, Gallati H, Buller HR. Elimination of interleukin 6 attenuates coagulation activation in experimental endotoxemia in chimpanzees. J Exp Med 1994;179:1253-1259.

81.Van de Water L, Carr JM, Aronson D. Analysis of elevated fibrin (ogen) degradation product levels in patients with liver disease. Blood 1986;67:1468-1473.

82.Vanschoonbeek K, Feijge MA, Paquay M, Rosing J, Saris W, Kluft C, Giesen PL, de Maat MP, Heemskerk JW. Variable hypocoagulant effect of fish oil intake in humans: modulation of fibrinogen level and thrombin generation. Arterioscler Thromb Vasc Biol. 2004;24:1734-1740.

83.Wang D, Wei J, Hsu K, Jau J, Lieu MW, Chao TJ, Chen HI. Effects of nitric oxide synthase inhibitors on systemic hypotension, cytokines and inducible nitric oxide synthase expression and lung injury following endotoxin administration in rats. J Biomed Sci 1999;6:28-35.

84.Wichterman A, Baue AE, Chaudry IH. Sepsis and septic shock-a review of laboratory models and a proposal. J of Surgical Research 1980;29:189-201.

85.Worthen GS, Seccombe JF, Clay KL, Guthrie LA, Johnston RB. The priming of neutrophils by lipopolysaccharides for production of intracellular platelet-activating factor: potential role in mediation of enhanced superoxide secretion. J Immunol 1989;140:3553-3559.

86.Wright CE, Rees DD, Moncada S. Protection and pathological roles of nitric oxide in endotoxin shock. Cardiovasc Res 1992;26:48-57.

87.Yan JJ, Jung JS, Lee JE, Lee J, Huh SO, Kim HS, Jung KC, Cho JY, Nam JS, Suh HW, Kim YH, Song DK. Therapeutic effects of lysophosphatidylcholine in experimental sepsis. Nat Med 2004;10:161-167.

88.Yao Z, Foster P, Gross G: Monophosphoryl lipid A protects against endotoxic via inhibiting neutrophil intravascular coagulation. Circ Shock 1994;43:107-114.

89.Yelich MR. Glucoregulatory, hormonal, and metabolic responses to endotoxicosis or cecal ligation and puncture sepsis in the rat: a direct comparison. Circ Shock 1990;31:351-363.

90.Ziegler EJ, Fisher CJ Jr, Sprung CL, Straube RC, Sadoff JC, Foulke CE, Wortel CH, Fink MP, Dellinger RP, Teng NN. Treatment of gram-negative bacteremia and septic shock with HA-1A humam monoclonal antibody against endotoxin. N Engl J Med 1991;324:429-436.
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