Vol. 274, Issue 6, R1556-R1560, June 1998
Evidence for a role of kallikrein-kinin system in patients
with shock after blunt trauma
Katsuhiko
Sugimoto1,
Mitsuhiro
Hirata2,
Masataka
Majima3,
Makoto
Katori3, and
Takashi
Ohwada2
1 Department of Emergency and
Critical Care Medicine, Showa University School of Medicine,
1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666; and
Departments of 2 Traumatology and
Critical Care Medicine and
3 Pharmacology, Kitasato
University School of Medicine, 1-15-1 Kitasato,
Sagamihara, Kanagawa 228-8555, Japan
Bradykinin (BK) is activated via plasma
and/or tissue kallikrein-kinin (K-K) system pathways during
hypotension after blunt trauma. The precise role of the K-K system in
human subjects has not been defined. We developed a new method for
measuring levels of BK in the blood and examined the role of the K-K
system in patients with shock after trauma. Eight patients were entered into this study. We measured the levels of a high-molecular-weight kininogen (HMWK), a low-molecular-weight kininogen (LMWK), BK, and
(1
5)-BK in the blood of patients in an unstable state
(Pre) and a stable state (Post). At Pre, the blood BK level was
significantly elevated, the HMWK and LMWK levels were significantly
lower, and the (15)-BK level was significantly higher than the
respective levels at Post. Our data suggest a significant role for the
K-K system in the pathogenesis of shock after blunt trauma. This newly developed method for determination of the activation of the plasma K-K
system appears to be useful for determining the severity of a trauma.
bradykinin; hemorrhage
