Related Experiment Videos
Plasma levels of activated protein C-protein C inhibitor complex in patients with hypercoagulable states
R Watanabe1, H Wada, M Sakakura
1Second Department of Internal Medicine, Mie University School of Medicine, Tsu-city, Mie-ken, Japan.
Insights
Activated protein C-protein C inhibitor (APC-PCI) complex levels are elevated in various thrombotic conditions, including disseminated intravascular coagulation (DIC). Measurements of APC-PCI and APC-alpha(1)-antitrypsin (AT) complexes show diagnostic potential for DIC and arterial thrombosis.
Area of Science:
- Biochemistry
- Hematology
- Thrombosis Research
Background:
- The protein C pathway plays a crucial role in regulating coagulation.
- Disseminated intravascular coagulation (DIC) is a complex thrombotic disorder with significant morbidity.
- Biomarkers for early and accurate diagnosis of thrombotic conditions are essential.
Purpose of the Study:
- To investigate the diagnostic utility of activated protein C (APC) complexes in thrombotic disorders.
- To evaluate plasma levels of APC-PCI and APC-alpha(1)-AT complexes in patients with DIC and other conditions.
- To explore the potential of these complexes as biomarkers for arterial and venous thrombosis.
Main Methods:
- Measurement of plasma levels of APC-PCI complex, APC-alpha(1)-AT complex, and protein C inhibitor (PCI).
- Analysis of thrombin-antithrombin complex (TAT), plasmin-alpha(2)-plasmin complex (PPIC), D-dimer, and soluble fibrin monomer (SFM).
- Receiver operating characteristic (ROC) analysis to assess diagnostic accuracy for DIC.
Main Results:
- Plasma APC-PCI complex levels were significantly increased in patients with DIC, TTP, AMI, PE, DVT, and undergoing hemodialysis (HD).
- APC-PCI and APC-alpha(1)-AT complexes were elevated in pre-DIC stages and decreased after DIC treatment.
- Soluble fibrin monomer (SFM) and APC-PCI complex showed high diagnostic utility for DIC via ROC analysis.
Conclusions:
- APC-PCI and APC-alpha(1)-AT complexes may serve as valuable diagnostic markers for DIC.
- Elevated APC-PCI complex levels suggest potential utility in diagnosing arterial thrombosis.
- The protein C pathway components warrant further investigation as biomarkers for thrombotic diseases.
Abstract:
Plasma levels of activated protein C (APC)-protein C inhibitor (PCI) were significantly increased in patients with disseminated intravascular coagulation (DIC), thrombotic thrombocytopenic purpura (TTP), acute myocardial infarction (AMI), pulmonary embolism (PE), or deep vein thrombosis (DVT) and in patients undergoing hemodialysis (HD). Plasma levels of APC-alpha(1)-antitrypsin (AT) complex were significantly increased in patients with DIC and in those with TTP. Plasma levels of PCI were significantly decreased in patients with DIC, non-DIC, or TTP and in those undergoing HD. In the pre-DIC stage, the plasma levels of APC-PCI complex were significantly increased but not those of APC-alpha(1)-AT complex. These data suggest that measurements of APC-PCI complex and APC-alpha(1)-AT complex may be useful for the diagnosis of DIC. After treatment of DIC, the plasma levels of APC-PCI complex and APC-alpha(1)-AT complex were significantly decreased, but not those of PCI. Plasma levels of thrombin-antithrombin complex (TAT), plasmin-alpha(2)-plasmin complex (PPIC), D-dimer, and soluble fibrin monomer (SFM) were markedly increased in patients with DIC or pre-DIC and were moderately increased in patients with non-DIC, TTP, AMI, PE, or DVT and in those undergoing HD. The receiving operating characteristic (ROC) analysis showed that SFM and the APC-PCT complex are useful markers for diagnosis of DIC. The specificity of plasma TAT and PPIC levels was low. The positive rate of APC-PCI complex was higher than 90% with DIC, TTP, AMI, PE, and it was higher than 60% with DVT and HD. Since the APC-PCI complex was elevated not only in patients with venous thrombosis but also in those with arterial thrombosis, components of the protein C pathway might be useful markers for the diagnosis of arterial thrombosis.