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Clinical studies on plasma fibronectin and factor XIII; with special reference to hyperlipoproteinemia
Insights
Plasma factor XIII, fibronectin, and cholinesterase levels differ in liver disease and lipid disorders. Decompensated cirrhosis shows decreased levels, while hypertriglyceridemia and nephrotic syndrome show increased levels, suggesting altered hepatic synthesis.
Area of Science:
- Biochemistry
- Clinical Medicine
- Pathophysiology
Background:
- Plasma proteins like factor XIII and fibronectin play roles in coagulation and tissue repair.
- Liver function significantly impacts the synthesis and regulation of various plasma proteins.
- Dyslipidemia and nephrotic syndrome are associated with altered metabolic processes that may affect protein levels.
Purpose of the Study:
- To investigate the levels of plasma factor XIII, plasma fibronectin, and serum cholinesterase in patients with decompensated cirrhosis, hyperlipoproteinemia, and nephrotic syndrome.
- To compare these levels with those of healthy control subjects.
- To explore potential mechanisms, such as accelerated hepatic synthesis, underlying observed changes.
Main Methods:
- Comparative analysis of plasma and serum protein levels.
- Inclusion of age-matched normal weight normolipidemic control subjects.
- Categorization of patient groups based on specific liver and lipid disorders (decompensated cirrhosis, hyperlipoproteinemia types IIa, IIb, IV, and nephrotic syndrome).
Main Results:
- Markedly decreased levels of factor XIII, fibronectin, and cholinesterase were observed in decompensated cirrhosis.
- Levels remained unchanged in hyperlipoproteinemia type IIa.
- Increased levels of factor XIII and fibronectin were found in hypertriglyceridemic subjects (types IIb and IV) and hyperlipidemic nephrotic patients.
Conclusions:
- Decompensated cirrhosis is associated with reduced levels of key plasma proteins.
- Accelerated hepatic synthesis of factor XIII and fibronectin may occur in nephrotic syndrome and endogenous hypertriglyceridemia.
- Elevated factor XIII and fibronectin in certain conditions could contribute to more resistant mural thrombi.
Abstract:
When compared to age-matched normal weight normolipidemic control subjects, plasma factor XIII, plasma fibronectin and serum cholinesterase levels were found to be markedly decreased in patients with decompensated cirrhosis of the liver, not significantly changed in hyperlipoproteinemia type IIa (heterozygous subjects) and increased in hypertriglyceridemic subjects (type IIb and IV) as well as in hyperlipidemic nephrotic patients. A possible accelerated hepatic synthesis of certain plasma proteins including factor XIII and fibronectin in patients with the nephrotic syndrome as well as in endogenous hypertriglyceridemia is envisaged. It is also considered that mural thrombi, richer in factor XIII and fibronectin, would be more resistant to fibrinolysis and more readily attached to subendothelial structures.