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[Molecular marker for detecting hypercoagulable state]
1Department of Laboratory Medicine, Oita Medical University.
Insights
New molecular markers like FM.Oita and FDP.Oita can detect hypercoagulable states. These markers, measuring both coagulation and fibrinolysis, offer a more detailed indicator of thrombotic risk than existing methods.
Area of Science:
- Biochemistry
- Hematology
- Clinical Chemistry
Context:
- Intravascular coagulation and fibrinolysis are critical in various diseases.
- Early detection of hypercoagulable and pre-thrombotic states is crucial for patient outcomes.
- Existing markers may lack the sensitivity or specificity for early detection.
Purpose:
- To identify sensitive molecular markers for assessing intravascular coagulative-fibrinolytic activity.
- To compare the diagnostic utility of novel assays (FM.Oita, SFMC.Oita, FDP.Oita) with existing methods.
- To establish reliable indicators for early detection of hypercoagulable and pre-thrombotic states.
Summary:
- Assessed coagulative and fibrinolytic markers in patients with DIC, thrombosis, AMI, sepsis, cancer, and diabetes.
- Found increased coagulative and fibrinolytic activity in all disease groups compared to healthy subjects.
- Identified soluble fibrin monomer complexes (FM.Oita, SFMC.Oita) and thrombin-antithrombin III complex (TAT) as key coagulation markers, and FDP.Oita as a sensitive fibrinolytic marker.
Impact:
- FM.Oita and FDP.Oita show a strong correlation, offering a more detailed indicator of coagulative-fibrinolytic balance than traditional ratios.
- High-sensitivity assays like FDP.Oita demonstrate superior detection sensitivity compared to commercially available methods.
- Establishing criteria based on these markers could lead to earlier diagnosis and intervention for thrombotic disorders.
Abstract:
We measured various coagulable factors and molecular markers in plasma and serum in the disease group including DIC, DIC suspect, thrombosis, acute myocardial infarction, angina pectoris, sepsis, malignant tumor and type II diabetes and the healthy subject group, and surmised the intravascular coagulative-fibrinolytic activity in each disease group compared with the healthy group. Additionally we selected parameters useful for early detection of the pre-thrombotic state and hypercoagulable state. As a result, of the parameters for the coagulative system, those considered useful were the assay of soluble fibrin monomer complexes using the synthetic substrate (FM.Oita), assay of soluble fibrin monomer complexes using HPLC(SFMC.Oita) and thrombin-anti-thrombin III complex (TAT) in this order. Of the parameters for the fibrinolytic system, those considered useful were FDP assay using ELISA (FDP.Oita) and plasmin-alpha 2 plasmin inhibitor complex (PIC). This FDP.Oita had a considerably high detection sensitivity compared with the FDP assay (Diayatron Co.) using the latex photometric immunoassay which has been commercially available. When measurement was made with plasma and serum in the subject disease group as the sample by the high sensitivity assays mentioned above, it was made clear that both the coagulative activity and fibrinolytic activity are increased, albeit with some differences in intensity, in all the disease groups compared with the healthy group. In order for the hypercoagulable state and pre-thrombotic state to be detected, it is important to know the balance between the coagulative activity and fibrinolytic activity. According to the results of the present experiment, a significant directly proportional correlation was recognized between FM.Oita and FDP.Oita and between TAT and FDP.Oita. Therefore, examination of these ratios will be a more detailed indicator of coagulative-fibrinolytic activity than the TAT/PIC ratio, PAI-1/TPA ratio and ATIII/alpha 2 PI ratio hitherto in use. If useful molecular markers such as FM.Oita are measured over time in various cases and these data are compiled and analyzed statistically, it will not be long before the criteria for the hypercoagulable state and pre-thrombotic state are established.