Atryn and DIC.
Dear Mouton in medicine they say the questions never change,,only the answers. My comments involve a good deal of speculation based on some known facts and of course alot more that is not known.
Def; Hypercoagulability: a state in which the blood is more likely to clot than normal. This can be due to congenital conditions, eg H-AT3 deficiency or aquired; eg 2ndary to malignancies, trauma, stasis or infections including DIC.
Although you do not spell it out one question this paper raises is it possible Atryn might improve survival following DIC without having much effect on the hypercoagulation.
It might work like this ( speculation----->) when you think AT3, think serine protienase inhibitor. when you think serine protienase, think cascade systems. Cascade systems operate in coagulation and in the immune system. Their general design involves a series of chemical (enzymatic) reactions in which the initial reaction yields an enzyme which then triggers a subsequent reaction which yields a product which triggers the next reaction and so forth until the end result,eg in the coagulation cascade the final product is fibrin, ie the clot.
The important point to understand about these reaction is they take time and a concentration of product to procede to the next step. Why does the body use these systems? Basically cascade system are used when it is important to act locally to protect the body, eg localized bleeding, but the consequenses of wide dissemmination of the effect would be catastrophic, eg generalised clotting in the blood stream.
The body's cascade system utilise serine proteinases. Since AT3 is a serine proteinase inhibitor,, think of Atryn as a cascade blocker. Atryn also effects the cascade of the compliment system (think immune system). There are other systems eg the embryological system where cellular apoptosis is a major factor in developing body morphology, this is probably also controlled by a cascade system. A recent paper has shown AT3 blocks the realease of tumor necrosis factor released from monocytes. These are thought to be important in DIC. It may Atryn's effect on the other cascades triggered in DIC may be more important than its effect on the coagulation cascade
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