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Clinical Science (1998) 95, (459465) (Printed in Great Britain)
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| Administration of albumin to patients with sepsis syndrome: a possible beneficial role in plasma thiol repletion |
| Gregory J. QUINLAN*, Michael P. MARGARSON, Sharon MUMBY*, Timothy W. EVANS* and John M. C. GUTTERIDGE* |

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*Unit of Critical Care, Royal Brompton Hospital and Imperial College of Science, Technology and Medicine NHLI, Sydney St, London SW3 6NP, U.K., and Magill Department of Anaesthetics, Chelsea and Westminster Hospital, Fulham Road, London SW10 9NH, U.K.
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Key words: albumin, antioxidant, plasma thiols, sepsis syndrome.Correspondence:
Dr J. M. C. Gutteridge.
1. Albumin is often administered intravenously to critically
ill patients as a volume expander, to combat hypoalbuminaemia, and to decrease
hyperbilirubinaemia. There is, however, an ongoing debate concerning the
therapeutic benefit of the former which is an expensive form of treatment.
2. Albumin has several biological functions, in particular
as a ligand binder. It also acts as an extracellular transition metal ion-binding
and radical-scavenging antioxidant. These functions are influenced by the
presence of an exposed thiol group (cys 34) on the surface of the albumin
molecule.
3. The ability of infused albumin to influence the plasma
thiol pool, and hence antioxidant potential, was investigated in patients
with sepsis syndrome.
4. Plasma thiol levels rose rapidly after albumin infusion
and remained elevated even after plasma albumin levels had declined significantly,
due to interstitial leakage. Data are suggestive of some form of thiol
exchange in the plasma of these patients between albumin and molecules
containing oxidized thiol groups.
5. Administration of albumin to patients with sepsis syndrome
leads to a sustained increase in plasma thiols. Thiols have several important
antioxidant functions, and thiol repletion in these patients, who are known
to suffer from oxidative stress, may have beneficial antioxidant effects.
Antioxidant repletion may represent an important facet of clinically administered
albumin.
Received 21 May 1998; accepted 27 May 1998
The Biochemical Society and the Medical Research Society ©
1998
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