[Review. The intensive medical care relevance of plasma fibronectin]

Abstract

Plasma Fibronectin (Fn) has been viewed as an essential opsonic mediator of the clearance function of the reticuloendothelial system (RES). An acute depletion of Fn would thus weaken the RES defense potential, which could be restored by Fn repletion. This concept, which was developed by Saba, has attracted considerable attention. Upon closer inspection, however, it turns out to be more complex and less clear cut than is commonly appreciated. The recent interest of acute care physicians is focussed on the behaviour of Fn during intravascular coagulation, organ failure, and sepsis. However, the informative content of plasma Fn levels in this setting is limited, too. The behaviour of Fn is only one part of a broader plasma protein "depletion and recovery syndrome" and therapeutic effects of Fn repletion have as yet not been adequately documented by controlled clinical trials. The use of plasma fibronectin as a part of intensive care is therefore premature, and the concept underlying its use requires further investigation.