Elevated plasma levels of fibrin degradation products by granulocyte-derived elastase in patients with disseminated intravascular coagulation.
Plasma levels of granulocyte-derived elastase (GE-XDP), D-dimer, and soluble fibrin (SF) were examined in 177 patients with disseminated intravascular coagulation (DIC) of various etiologies. Plasma levels of GE-XDP and D-dimer, but not SF, were significantly high in patients with sepsis and solid cancer. The ratio of GE-XDP/ D-dimer was significantly high in patients with trauma, burn, and sepsis, suggesting that fibrinolysis due to GE-XDP may be dominant in DIC. Plasma levels of GE-XDP and D-dimer, but not SF, were significantly high in patients with overt DIC and correlated with DIC score. Plasma levels of GE-XDP, but not SF, correlated significantly with D-dimer. Plasma levels of D-dimer, but not SF, correlated significantly with plasmin plasmin inhibitor complex (PPIC). Plasma levels of GE-XDP and D-dimer, but not SF, were significantly high in nonsurvivors. Plasma levels of GE-XDP, but not SF, correlated significantly with sepsis-related organ failure assessment (SOFA) score. These results suggest that GE-XDP is a potentially useful marker for the diagnosis of overt-DIC and as a predictor of organ failure-related outcome.
Matsumoto
Takeshi
T
Second Department of Internal Medicine, Mie University School of Medicine, Tsu, Japan.
Wada
Hideo
H
Nobori
Tsutomu
T
Nakatani
Kaname
K
Onishi
Katsuya
K
Nishikawa
Masakatsu
M
Shiku
Hiroshi
H
Kazahaya
Yumiko
Y
Sawai
Tokio
T
Koike
Kaoru
K
Matsuda
Michio
M
D015415:Biomarkers; D004211:Disseminated Intravascular Coagulation / Q000097:blood* / Q000201:enzymology* / Q000473:pathology; D005260:Female; D005337:Fibrin / Q000378:metabolism*; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005341:Fibrinolysin / Q000037:antagonists & inhibitors / Q000378:metabolism; D006801:Humans; D019272:Leukocyte Elastase / Q000378:metabolism*; D008297:Male; D010949:Plasma / Q000378:metabolism*; D011485:Protein Binding; D018805:Sepsis / Q000097:blood / Q000201:enzymology; D012995:Solubility
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D005337:Fibrin; D019272:Leukocyte Elastase; D005341:Fibrinolysin