Bench-to-bedside review: The role of activated protein C in maintaining endothelial tight junction function and its relationship to organ injury

Mark R Looney¹ and Michael A Matthay¹^,2

¹Department of Medicine, Cardiovascular Research Institute, University of California, 505 Parnassus Avenue, San Francisco, California 94143-0130, USA

²Department of Anesthesia, University of California, 505 Parnassus Avenue, San Francisco, California 94143-0130, USA

author email corresponding author email

Critical Care 2006, 10:239doi:10.1186/cc5099


Published:	7 December 2006

See related commentary by Regnault and Levy, http://ccforum.com/content/11/1/103 and related letter by Li, http://ccforum.com/content/11/1/407

Abstract

Activated protein C (APC) has emerged as a novel therapeutic agent for use in selected patients with severe sepsis, even though the mechanism of its benefit is not well established. APC has anticoagulant, anti-inflammatory, antiapoptotic, and profibrinolytic properties, but it is not clear through which of these mechanisms APC exerts its benefit in severe sepsis. Focus has recently turned to the role of APC in maintaining endothelial barrier function, and in vitro and in vivo studies have examined this relationship. This article critically reviews these studies, with a focus on potential mechanisms of action.