Prophylactic Administration of Urinary Trypsin Inhibitor Prevents Postoperative Hyperamylasemia after R2 Gastrectomy in Patients with Gastric Cancer

Korenaga, Daisuke; Orita, Hiroyuki; Kakeji, Yoshihiro; Haraguchi, Masanobu; Maehara, Yoshihiko; Sugimachi, Keizō

doi:10.1159/000129155

Cited by 8 publications

(3 citation statements)

References 13 publications

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“…It may modulate the polymorphonuclear cell activity [5], thus explaining a part of the therapeutic effect of bikunin purified from human urine. The latter has been proposed as preventive treatment for shock or pancreatitis [6,7].…”

Section: Introductionmentioning

confidence: 99%

Preparation and Properties of a Therapeutic Inter-Alpha-Trypsin Inhibitor Concentrate from Human Plasma

Michalski¹,

Piva²,

Balduyck³

et al. 1994

Vox Sanguinis

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Inter-α-trypsin inhibitor (ITI) is a serine protease inhibitor found in human plasma. Its antiprotease activity is due to bikunin which is effective in various types of experimental shock and pancreatitis. Therefore ITI, which releases bikunin by proteolytic cleavage, could be of therapeutic interest. A method for the large- scale isolation of ITI from human plasma is described. ITI was purified from the prothrombin complex concentrate (PCC) by diethylaminoethyl-Sepharose fast- flow chromatography followed by a chromatographic step on immobilized heparin designed to remove C4, factor X and protein C. With this procedure, which was performed under mild conditions, a homogeneous preparation of native ITI was obtained, as demonstrated by electrophoretic and chromatographic analyses. ITI maintained its biological activity, as exhibited by its specific antitryptic activity of 420±65 IU/g. In order to decrease or eliminate the risk of transmission of viral disease due to lipid-enveloped viruses, the process incorporated a solvent- detergent treatment. Animal studies on the final product revealed no adverse side-effects in terms of toxicity, thrombogenicity or hypotension. This preparation appears suitable for therapeutic evaluation in animal experimental models.

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Section: Introductionmentioning

confidence: 99%

Preparation and Properties of a Therapeutic Inter-Alpha-Trypsin Inhibitor Concentrate from Human Plasma

Michalski¹,

Piva²,

Balduyck³

et al. 1994

Vox Sanguinis

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“…A prospective randomized study was performed to determine whether prophylactic administration of ulinastatin could prevent pancreatic damage caused by R2 gastrectomy in patients with gastric cancer and it was shown to prevent postoperative hyperamylasemia [5]. In another study, 16 patients with carcinoma of the digestive tract who also suffered from circulatory insufficiency were divided into a ulinastatin group (n = 9) and a control group (n = 7) to assess the effect of ulinastatin on surgical stress; ulinastatin was concluded to be effective in preventing an excessive reaction to major surgery [6].…”

Section: Introductionmentioning

confidence: 99%

Intravenous Ulinastatin Therapy for Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Pediatric Patients

Inamo¹,

Okubo

Wada

et al. 2002

Int Arch Allergy Immunol

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Background: More effective therapy is needed for the treatment of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). The clinical efficacy of intravenous ulinastatin therapy was investigated in 3 Japanese pediatric patients with SJS or TEN. Methods: Ulinastatin was given to 1 pediatric SJS patient and 2 pediatric TEN patients within 7 days (patient 1; SJS), 6 days (patient 2; TEN), or 4 days (patient 3; TEN) after the onset of the skin rash. Ulinastatin was administered intravenously at a dose of 7,500 U/kg/day (maximum dose: 300,000 U/day). No corticosteroids were given. After the skin lesions resolved, the ulinastatin dose was reduced to between 2,500 and 5,000 U/kg/day as maintenance therapy and then the drug was withdrawn. Results: Erythema, fatigue, and fever improved within 12–36 h of starting the ulinastatin infusion, and the skin lesions resolved completely after 4–7 days of ulinastatin therapy. None of the patients had cutaneous or ocular sequelae. No patient developed secondary infection or relapse and ulinastatin therapy caused no side effects. Conclusion: Ulinastatin dramatically reduced the febrile period with no adverse effects and was very safe in this study. Ulinastatin appears to be a useful and effective therapy for controlling SJS and TEN without sequelae.

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“…Bikunin has been used therapeutically in preliminary studies to reduce tissue damage associated with surgical complications such as shock [19] and hyperamylasaemia [20].…”

Section: Introductionmentioning

confidence: 99%

Effects of inter-α-inhibitor and several of its derivatives on calcium oxalate crystallization in vitro

DEAN¹,

KANELLOS²,

PHAM³

et al. 2000

Clinical Science

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The bikunin peptide chain of the protease inhibitor inter-alpha-inhibitor (IalphaI) has been reported to be an inhibitor of calcium oxalate (CaOx) crystallization, and hence has been proposed as having a role in CaOx kidney stone formation. However, further experimental evidence is required to assess if fragments of IalphaI other than bikunin may play a role in the regulation of crystallization events in stone formation. The aim of the present study was to assess the effects of IalphaI and several of its derivatives on CaOx crystallization in a seeded inorganic system and to compare these effects with those of a known inhibitor of crystallization, prothrombin. IalphaI was purified from a preparation of human plasma and fragmented by alkaline hydrolysis, and two of its peptide chains, bikunin and heavy chain 1 (H1), were purified further by HPLC. Their purity was confirmed by SDS/PAGE. Using Coulter counter and [(14)C]oxalate analysis and scanning electron microscopy, IalphaI, its H1 chain and bikunin from urine and from plasma were shown to be relatively weak inhibitors of CaOx crystallization in vitro at expected physiological concentrations. It was concluded that members of the IalphaI family may not be as important in kidney stone formation as has been generally proposed, although further studies are required before a possible role for IalphaI and its fragments in stone formation can be unambiguously discounted.

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Prophylactic Administration of Urinary Trypsin Inhibitor Prevents Postoperative Hyperamylasemia after R2 Gastrectomy in Patients with Gastric Cancer

Cited by 8 publications

References 13 publications

Preparation and Properties of a Therapeutic Inter-Alpha-Trypsin Inhibitor Concentrate from Human Plasma

Preparation and Properties of a Therapeutic Inter-Alpha-Trypsin Inhibitor Concentrate from Human Plasma

Intravenous Ulinastatin Therapy for Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Pediatric Patients

Effects of inter-α-inhibitor and several of its derivatives on calcium oxalate crystallization in vitro

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