title: Increased activated protein C-protein C inhibitor complex levels in patients with pulmonary embolism.
abstract: Activated protein C (APC)-protein C inhibitor (PCI) complex level was examined in 35 patients with acute pulmonary embolism (PE) and in 20 healthy volunteers. Thrombin-antithrombin III complex, plasmin alpha 2 plasmin inhibitor complex, and fibrin-D-dimer levels were significantly increased in the patients with PE compared to levels in healthy volunteers. Levels of plasminogen activator inhibitor-I, tissue type plasminogen activator, and von Willebrand factor antigens were also significantly increased in patients with PE. Plasma level of APC-PCI complex was increased in most patients with PE and APC-alpha 1 antitrypsin complex level was increased in 13 patients. These complexes were not detected in healthy volunteers. These findings suggested that plasma protein C was activated in patients with PE, and that PCI was the major inhibitor of APC generated in this condition. Thus, regulation of the protein C pathway might play an important role in the pathogenesis of PE.
authors.affiliation: 2nd Department of Internal Medicine, Mie University School of Medicine, Tsu-city, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Minamikawa
authors.forename: H
authors.initials: H
authors.lastname: Wada
authors.forename: Y
authors.initials: Y
authors.lastname: Wakita
authors.forename: M
authors.initials: M
authors.lastname: Ohiwa
authors.forename: M
authors.initials: M
authors.lastname: Tanigawa
authors.forename: K
authors.initials: K
authors.lastname: Deguchi
authors.forename: N
authors.initials: N
authors.lastname: Hiraoka
authors.forename: H
authors.initials: H
authors.lastname: Huzioka
authors.forename: J
authors.initials: J
authors.lastname: Nishioka
authors.forename: T
authors.initials: T
authors.lastname: Hayashi
mesh_terms: D000328:Adult; D000933:Antifibrinolytic Agents; D000990:Antithrombin III / Q000378:metabolism; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005341:Fibrinolysin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D010447:Peptide Hydrolases / Q000378:metabolism; D011486:Protein C / Q000037:antagonists & inhibitors* / Q000378:metabolism*; D011655:Pulmonary Embolism / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D000979:alpha-2-Antiplasmin / Q000378:metabolism
chemical_list: D000933:Antifibrinolytic Agents; D005338:Fibrin Fibrinogen Degradation Products; D011486:Protein C; D000979:alpha-2-Antiplasmin; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; C037742:plasmin-plasmin inhibitor complex; D000990:Antithrombin III; D010447:Peptide Hydrolases; D005341:Fibrinolysin