ELECTRON MICROSCOPIC STUDY OF THE PHAGOCYTIC FIBRIN-CLEARING MECHANISM.
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Biomedical subjects
Publications and source records attributed to L LEE.
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In the presence of reticuloendothelial blockade, the intravenous injection of a protein antigen into specifically immunized rabbits or the infusion of soluble immune complexes into normal animals has been shown to result in the production of bilateral renal cortical necrosis. The similarity in the pathogenesis of this lesion and that seen in the classical generalized Shwartzman reaction produced by bacterial endotoxins is indicated by (a) the failure of both lesions to develop in animals pretreated with large doses of heparin, (b) by the finding of "heparin-precipitable fibrinogen" in the circulation, and (c) by the presence of massive fibrin deposits within the glomerular capillaries. These findings indicate that antigen-antibody reactions in vivo are capable of activating the blood coagulation system and that the mode of action of bacterial endotoxins may have an immunological basis.
In rabbits given an intravenous infusion of thrombin or an injection of endotoxin, immunohistochemical examination of the tissues, using conjugated antiserum against rabbit fibrin, showed bright intracytoplasmic staining in many of the phagocytic cells of the liver and spleen. In normal rabbits as well as in animals injected with large doses of heparin prior to thrombin or endotoxin administration, no such intracellular staining was observed. The findings of this study substantiate the hypothesis that fibrin aggregates formed in the circulating blood during low grade intravascular coagulation are largely removed by the reticuloendothelial system.
Intravenous injections of endotoxin or infusions of thrombin in the rabbit initiate intravascular coagulation but do not usually result in massive deposition of fibrin. It has been proposed that the reticuloendothelial system may function efficiently in the removal of circulating fibrin; its blockade permits reproduction of all of the features of the generalized Shwartzman reaction by infusions of thrombin. In the rabbit the reticuloendothelial system may constitute the major protective mechanism against the vasculo-occlusive lesions of the generalized Shwartzman reaction, which appears to be the direct consequence of intravascular fibrin formation and deposition.
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Rabbits given single injections of endotoxin and then skin-tested with endotoxin from 1 day to 1 month later exhibit accelerated skin reactions resembling the Arthus phenomenon. Injection of one endotoxin alters the subsequent reactivity of rabbits to other endotoxins as well. The state of altered reactivity can be transferred with serum, and appears to be related to the presence of non-precipitating cross-reactive antibody, rather than to specific precipitating antibody.
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