Blood levels of endothelin-1 and thrombomodulin in patients with disseminated intravascular coagulation and sepsis.
We evaluated the roles of plasma endothelin-1 and plasma thrombomodulin in the development of disseminated intravascular coagulation (DIC) in patients with sepsis. Plasma endothelin-1 was measured by radioimmunoassay (RIA). Plasma thrombomodulin and tumor necrosis factor-alpha (TNF-alpha) were measured by enzyme-linked immunosorbent assay (ELISA), and serum protein C (protein C) was measured by the synthetic substrate method. Endotoxin was measured by the Endospecy test, a synthetic substrate method. A new perchloric acid method was used for the pretreatment of plasma. Blood levels of endothelin-1 and thrombomodulin were significantly higher in patients with DIC than in those without DIC (p < 0.0001). Endothelin-1 and thrombomodulin levels were positively correlated (r = 0.8645, p = 0.0001), as were endothelin-1 and TNF-alpha levels (r = 0.5441, p = 0.0002). Thrombomodulin and protein C levels were negatively correlated (r = -0.5627, p = 0.0001). Endotoxin was elevated above the normal level 14.3% (6/42) for these patients. TNF-alpha is involved in the production of endothelin-1 and thrombomodulin, which play a role in the pathogenesis of DIC and whose blood levels reflect its severity.
Endo
S
S
Critical Care and Emergency Center, Iwate Medical University, Morioka, Japan.
Inada
K
K
Nakae
H
H
Takakuwa
T
T
Kasai
T
T
Yamada
Y
Y
Suzuki
T
T
Taniguchi
S
S
Yoshida
M
M
D000328:Adult; D004211:Disseminated Intravascular Coagulation / Q000097:blood*; D016232:Endothelins / Q000097:blood*; D004731:Endotoxins / Q000097:blood; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011486:Protein C / Q000378:metabolism; D018805:Sepsis / Q000097:blood*; D018180:Thrombomodulin / Q000378:metabolism*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D016232:Endothelins; D004731:Endotoxins; D011486:Protein C; D018180:Thrombomodulin; D014409:Tumor Necrosis Factor-alpha