Circulating activated protein C levels are not increased in septic patients treated with recombinant human soluble thrombomodulin

Autor: Tomotsugu Yasuda, Ikuro Maruyama, Tomohiro Eguchi, Yutaro Madokoro, Yasuyuki Kakihana, Takahiro Futatsuki, Shotaro Miyamoto, Hiroyuki Haraura, Nozomi Yashima, Hiroaki Furubeppu, Takashi Ito, Chinatsu Kamikokuryo, Takuro Arishima
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: Thrombosis Journal, Vol 16, Iss 1, Pp 1-7 (2018)
Thrombosis Journal
ISSN: 1477-9560
DOI: 10.1186/s12959-018-0178-0
Popis: Background Recombinant human soluble thrombomodulin (rTM) has been used for the treatment of disseminated intravascular coagulation in Japan, and an international phase III clinical trial for rTM is currently in progress. rTM mainly exerts its anticoagulant effects through an activated protein C (APC)-dependent mechanism, but the circulating APC levels after rTM treatment have not been clarified. This prospective observational study investigated plasma APC levels after rTM treatment. Methods Plasma levels of soluble thrombomodulin, thrombin-antithrombin complex (TAT), protein C, and APC were measured in eight septic patients treated with rTM. APC generation in vitro was assessed in the presence or absence of rTM. Results rTM significantly increased thrombin-mediated APC generation in vitro. In septic patients, soluble thrombomodulin levels were significantly increased during a 30–60-min period of rTM treatment and TAT levels were decreased. However, APC activity was not increased during the treatment period. Conclusions Plasma APC activity is not increased in septic patients treated with rTM. It is possible that APC acts locally and does not circulate systemically. Electronic supplementary material The online version of this article (10.1186/s12959-018-0178-0) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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