Systemic Inflammatory Response Syndrome in Non-human Primates Culminating in Multiple Organ Failure Acute Lung Injury and Disseminated Intravascular Coagulation

摘要

The Systemic Inflammatory Response Syndrome (SIRS) is a clinicopathological manifestation of over-exuberant acute phase inflammation caused by infectious or non-infectious etiologies. The systemic release of pro-inflammatory cytokines, chemokines, lipid and vasoactive mediators induces endothelial damage and microvascular thrombosis, potentially culminating in disseminated intravascular coagulation (DIC), acute respiratory distress syndrome (ARDS), and multiple organ dysfunction (MOD) or failure (MOF). We present five cases in the pig-tailed macaque and olive baboon where SIRS resulted in MOF, ARDS, DIC, and the Waterhouse-Friderichsen syndrome; each with gross and histological elements manifested as edema, deposition of fibrin, hemorrhage, and thrombosis. In the described cases, SIRS was the end-common pathway for multiple risk factors which parallel those documented in humans: major surgery, obstetric complications, and infection. The diagnosis of SIRS should be considered when evaluating non-human primate (NHP) cases of MOF manifesting with histological evidence of vascular leakage. Experimental manipulation of NHP models may be complicated by SIRS and accompanying rapid clinical decompensation. Such adverse events may compromise toxicological studies and should be avoided when possible.