Plasma tissue factor and tissue factor pathway inhibitor levels in patients with disseminated intravascular coagulation

Abstract

We measured the plasma levels of tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in patients with disseminated intravascular coagulation (DIC) to examine the relationship between TFPI and vascular endothelial cell injury. Plasma TF (273 ± 90 pg/ml) and TFPI (252 ± 125 ng/ml) levels were significantly increased in patients with DIC compared with non-DIC patients. Plasma TF antigen level was significantly increased in pre-DIC patients (285 ± 85 pg/ml), while the plasma TFPI level (152 ± 54 ng/ml) was not markedly increased in such a state. The plasma TF/TFPI ratio was high in the pre-DIC patients (2.10 ± 0.90), and low in the DIC patients (1.40 ± 0.87) and healthy volunteers (0.84 ± 0.26). There was no significant difference between the DIC patients with a good outcome and those with a poor outcome in terms of plasma TF levels, although the plasma TFPI level in the DIC patients with a good outcome (289 ± 133 ng/ml) was significantly higher than those with a poor outcome (187 ± 75 ng/ml). During the clinical course of DIC, plasma TF antigen was increased first, and an increase of the plasma TFPI level followed the increase in plasma TF level. These findings suggest that plasma TFPI is released from vascular endothelial cells and it may reflect vascular endothelial cell injury. It is conceivable that TF and TFPI may play an important role in the onset of DIC. Am.

Bothrops jararaca Venom Metalloproteinases Are Essential for Coagulopathy and Increase Plasma Tissue Factor Levels during Envenomation

“…In virtue of elevated FDP/fdp levels, thrombocytopenia, prolonged prothrombin time and fibrinogen consumption, which were also observed herein, snake envenomation has been associated with or may evolve to DIC [80]. Since high plasma TF levels have been described in patients with DIC [81], our results suggest that raised TF levels may have an important role in activating the blood coagulation cascade, especially in more severely envenomed patients, in which the local lesion is more extensive [2]. On the other hand, since hemostatic disturbances are rapidly recovered after antivenom therapy in mildly or moderately envenomed patients [2], the involvement of plasma TF in bleeding manifestations observed therein awaits clinical evaluation.…”

A link between a hemostatic disorder and preterm PROM: a role for tissue factor and tissue factor pathway inhibitor

“…Immunoreactive TFPI is 500 to 1000 times more abundant in the maternal plasma than TF [119]. Changes in this ratio have been observed in patients with disseminated intravascular coagulation (DIC) [119] and thrombotic thrombocytopenic purpura (TTP) [79].…”

“…Immunoreactive TFPI is 500 to 1000 times more abundant in the maternal plasma than TF [119]. Changes in this ratio have been observed in patients with disseminated intravascular coagulation (DIC) [119] and thrombotic thrombocytopenic purpura (TTP) [79]. Moreover, patients with DIC who had a poor outcome also had a higher TF/TFPI ratio [119], while patients with TTP had a significant increase in TFPI/TF ratio after treatment; the authors had proposed that this reflects an improvement in the hypercoagulable state associated with TTP [79].…”

Diagnosis of Overt Disseminated Intravascular Coagulation: A Comparative Study Using Criteria from the International Society Versus the Korean Society on Thrombosis and Hemostasis

“…Further, additional studies on universally applicable molecular markers such as D-dimer,11 antithrombin, protein C, soluble fibrin monomer,12 thrombin-antithrombin complex,13,14 tissue factor, and tissue factor pathway inhibitor15 are needed.…”