[Evaluation of plasma thrombomodulin (TM) levels in patients with liver disease]

Plasma TM levels in patients with various liver diseases were determined by using EIA. In normal subject (n = 58), it's concentration was 15.9 +/- 3.5 ng/ml (mean +/- SD). In liver diseases, the level increased: Acute hepatitis (n = 16), 23.0 +/- 6.5, chronic active hepatitis (n = 21) 22.2 +/- 6.6, compensated liver cirrhosis (n = 20) 27.8 +/- 10.1, decompensated liver cirrhosis (n = 14) 47.6 +/- 17.5, compensated liver cirrhosis with hepatocellular carcinoma (n = 7) 26.3 +/- 7.9, decompensated liver cirrhosis with hepatocellular carcinoma (n = 4) 46.0 +/- 11.8, and fulminant hepatitis (n = 9) 42.0 +/- 20.4. The percentages of abnormal values higher than 22.9 ng/ml, which is mean + 2SD in control subject was 38-100% in liver diseases, especially 100% in patients with liver cirrhosis or with fulminant hepatitis. There was little correlation between plasma TM levels and conventional liver function tests in various liver diseases. Immunohistochemical study of liver tissue showed that an increase of plasma TM level was partially caused by damage and regeneration of endothelial cell. Based on these results the measurement of plasma TM concentration could be an useful marker for detection of hepatic failure.