PubMed · 5566140
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A M Ehrly. 1971-07-24. [Rheologic problems in shock].. https://pubmed.ncbi.nlm.nih.gov/5566140/
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The effectiveness of alteplase and urokinase in restoring adequate hemodialysis blood-flow rates was examined. A retrospective review of the medical records of hemodialysis patients with central venous catheters receiving alteplase or urokinase for presumed catheter thrombosis between June 1997 and December 2000 was conducted. Patients received 1 mL of alteplase 1 mg/mL or 1 mL of urokinase 5000 units/mL in each catheter port. The choice of the thrombolytic agent was left to the prescriber. Effectiveness of thrombolysis was defined as achieving a posttreatment hemodialysis blood-flow rate of > 300 mL/min, maintained for at least 30 minutes during the dialysis session. Inclusion criteria included adherence to the thrombolytic protocol and the inability to achieve a hemodialysis blood-flow rate of > 300 mL/min during the first 60 minutes of the hemodialysis session despite at least one attempt to reposition the catheter. Both thrombolytic agents significantly increased the hemodialysis blood-flow rates. Patients with alteplase-treated catheters were twice as likely to achieve hemodialysis blood-flow rates of > 300 mL/min (p = 0.0134) and were more likely to complete hemodialysis during that session (93% versus 70%, p = 0.0234). The percentage of functioning catheters at a subsequent hemodialysis session did not significantly differ between groups (p = 0.0806). The majority of patients in both treatment groups required no further interventions. Hemodialysis blood-flow rates increased after either alteplase 1 mg/mL per port or urokinase 5000 units per port was used to clear presumed catheter thrombosis. Alteplase was more likely than urokinase to result in a hemodialysis blood-flow rate of > 300 mL/min.
Natural killer T (NKT) cells are important regulators of the immune system, but their trafficking machinery, including expression of chemokine receptors, has been poorly defined. Unlike other conventional T-cell populations, we show that most NKT cells express receptors for extralymphoid tissue or inflammation-related chemokines (CCR2, CCR5, and CXCR3), while few NKT cells express lymphoid tissue-homing chemokine receptors (CCR7 and CXCR5). A population with homing potential for lymph nodes (L selectin(+) CCR7(+)) exists only within a small subset of CD4 NKT cells. We show differential expression of chemokine receptors among NKT cell subsets: CCR4 is mainly expressed by a high cytokine (interleukin-4/interleukin-2)-producing (CD4) NKT subset, while CCR1, CCR6, and CXCR6 are preferentially expressed by the low cytokine-producing CD8 and CD4(-)CD8(-) subsets. In line with this, TARC/CCL17 (a CCR4 ligand) induces preferential chemotaxis of the CD4 NKT subset, while chemotactic activities of LARC/CCL20 (a CCR6 ligand) and MIP-1 alpha/CCL3 (a CCR1 ligand) are focused on the CD8 and CD4(-)CD8(-) NKT cells. We conclude that, unlike conventional naive, memory, or effector T cells, the entire NKT cell population expresses nonlymphoid tissue homing chemokine receptors, yet NKT cell subsets differ considerably from each other by displaying distinct and reciprocal expression patterns of some chemokine receptors. Our results identify chemokine receptors that are potentially important for trafficking of human blood NKT cell subsets and reveal their function (cytokine production capacity)-dependent differential trafficking potentials.
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