Decrease of fibronectin following repeated infusion of highly substituted hydroxyethyl starch.

OBJECTIVE

Fibronectin (Fn) plays an important part in unspecific defense mechanisms because of its ability to mediate the binding of foreign-body particles, bacteria, collagen, and other macromolecules to phagocytising cells of the reticulo-endothelial system (RES). The aim of the present study was to examine the effect of a 10-day hemodilution therapy on Fn concentration in humans.

DESIGN

The patients were randomized and treated with either 10% hydroxyethyl starch (HES) 200/0.62 or 6% HES 200/0.62.

SETTING

Neurology department of an university clinic.

PATIENTS: We examined 12 patients with cerebrovascular perfusion disturbances.

INTERVENTIONS: The Fn concentration was determined using simple radial immunodiffusion.

RESULTS

The Fn concentration dropped significantly in all 12 patients (p < 0.01) in a dose-dependent manner beyond the dilution effect. 10% HES 200/0.62 caused a Fn decrease from 26.6 +/- 9.2 to 10.0 +/- 2.2 mg/dl (-62.2%), 6% HES reduced Fn from 25.5 +/- 9.9 to 15.0 +/- 3.2 mg/dl (-41.1%). In one patient there was a continuous decrease of Fn from 41.0 down to only 6.4 mg/dl.

CONCLUSION

According to the results of animal experiments, the decrease of Fn seems to indicate depression of the RES. Besides its defense function, Fn probably plays a role in embryogenesis, wound healing, and blood clotting. Therefore, we assume that the drug-induced reduction of Fn possibly has clinical relevance.