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Updated: Mar 20, 2026
Author Spotlight: High-Sensitivity Tissue Factor Activity Assay for Plasma Diagnosis
Published on: December 29, 2023
High intravascular tissue factor-but not extracellular microvesicles-in septic patients is associated with a high
Carolin Trepesch1, Ramona Nitzsche1, Aenne Glass2
1Institute of Medical Microbiology, Virology and Hygiene, Rostock University Medical Center, Schillingallee 70, 18057 Rostock, Germany.
Background:
Sepsis is associated with coagulation abnormalities, and a high content of intravascular tissue factor (TF) may contribute to the development of multisystem organ failure. Circulating microvesicles (MVs) are increased during sepsis and characterized by their phosphatidylserine content. It is unclear whether MVs-as a part of the host response to the infection-are beneficial or rather contribute to systemic complications in sepsis. In the present prospective clinical pilot study, we investigated whether plasma TF and MVs are associated with the risk of multiple organ failure and mortality.
Methods:
Thirty patients diagnosed with sepsis, severe sepsis, or septic shock were enrolled and classified as 19 survivors and 11 non-survivors. Blood samples were collected on the day of admission and then daily for up to 2 weeks. MVs and TF were quantified in plasma by ELISA.
Results:
Non-survivors had significantly higher TF concentrations on day 3 compared to survivors. Logistic regression analysis revealed that patients with high amounts of TF had significantly increased risk for severity of disease, according to high Simplified Acute Physiology Score II (SAPS II) scores (odds ratio 18.7). In contrast, a higher content of phosphatidylserine-rich MVs were apparently associated with a lower risk for mortality and multiple organ failure, although this was only a trend and the odds ratios were not significant.
Conclusions:
This study showed that a high amount of TF in septic patients is significantly associated with increased risk for disease severity, according to a high SAPS II score. Quantification of total MVs in plasma, independent from their cell origin, might be indicative for the outcome of patients in sepsis.
Insights
High levels of tissue factor (TF) in sepsis patients correlate with increased disease severity and mortality risk. Conversely, microvesicles (MVs) may indicate a better prognosis in sepsis patients.
Area of Science:
- Coagulation and Thrombosis Research
- Critical Care Medicine
- Sepsis Pathophysiology
Background:
- Sepsis often involves coagulation abnormalities, with intravascular tissue factor (TF) potentially driving organ failure.
- Circulating microvesicles (MVs) increase during sepsis; their role in host response and complications remains unclear.
Purpose of the Study:
- To investigate the association between plasma TF, MVs, and the risk of multiple organ failure and mortality in sepsis patients.
Main Methods:
- Prospective pilot study of 30 sepsis patients (19 survivors, 11 non-survivors).
- Plasma samples collected daily for up to 2 weeks.
- Quantification of TF and MVs using ELISA.
Main Results:
- Non-survivors exhibited significantly higher TF concentrations on day 3 compared to survivors.
- High TF levels were associated with increased disease severity (high SAPS II scores; OR 18.7).
- Higher phosphatidylserine-rich MVs showed a trend towards lower mortality and organ failure risk, though not statistically significant.
Conclusions:
- Elevated TF in sepsis patients is significantly linked to increased disease severity (high SAPS II score).
- Quantifying total MVs in plasma may serve as an indicator of patient outcomes in sepsis.
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