期刊论文详细信息
Thrombosis Journal
An evaluation of circulating activated TAFI in septic DIC: a case series and review of the literature
Takaaki Totoki1  Takashi Ito2  Midori Kakuuchi2  Nozomi Yashima2  Yasuyuki Kakihana2  Ikuro Maruyama3 
[1] Department of Anesthesiology & Critical Care Medicine, Kyushu University;Department of Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences;Department of Systems Biology in Thromboregulation, Kagoshima University Graduate School of Medical and Dental Sciences;
关键词: Disseminated intravascular coagulation;    Thrombin-activatable fibrinolysis inhibitor;    Sepsis;    Thrombomodulin;   
DOI  :  10.1186/s12959-022-00364-4
来源: DOAJ
【 摘 要 】

Abstract Background Administration of recombinant human soluble thrombomodulin (rTM) is often used in Japan to treat septic disseminated intravascular coagulation (DIC). Thrombin-activatable fibrinolysis inhibitor (TAFI) is a fibrinolysis inhibitor activated by the thrombin-thrombomodulin complex, however, it is unknown whether circulating activated TAFI is increased after rTM administration in patients with DIC. Furthermore, the relationship between TAFI activation and the prognosis of septic DIC is not defined yet. Case presentation We report a series of 8 patient’s TAFI activation with septic DIC treated by rTM. We sought to investigate the effect of rTM on TAFI activation and the association of plasma activated TAFI (TAFIa/ai) levels with the prognosis of septic DIC. Using plasma samples from clinical studies conducted from May 2016–March 2017 on eight patients with septic DIC at Kagoshima University Hospital, we measured plasma levels of total TAFI, TAFIa/ai, thrombin-antithrombin complex (TAT), prothrombin fragment 1 + 2 (F1 + 2), soluble fibrin (SF), antithrombin (AT), protein C (PC), protein S (PS), and plasminogen activator inhibitor-1 (PAI-1) before and after intravenous rTM administration. Then, we evaluated the relationship of these marker levels to prognosis. The thrombin-rTM complex activated TAFI in vitro in plasma from a healthy volunteer. However, TAFIa/ai levels did not significantly increase over baseline in the septic DIC patients after intravenous rTM administration. Baseline TAFIa/ai levels in non-survivors were significantly higher than those in survivors. Conclusions Plasma TAFIa/ai did not increase with rTM administration. Elevated baseline TAFIa/ai concentration may be a negative prognostic indicator in septic DIC. Larger studies are needed to confirm the in vivo effect of rTM on TAFI activation.

【 授权许可】

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