title: Plasma tissue factor pathway inhibitor levels in patients with acute pancreatitis.
abstract: BACKGROUND
  In acute pancreatitis (AP), disorders of the coagulation-fibrinolysis system are closely related to the severity of the AP and to organ dysfunctions. We previously reported that plasma tissue factor (TF) levels were elevated in patients with AP, particularly in cases of alcoholic AP with pancreatic necrosis. Tissue factor pathway inhibitor (TFPI) is a key regulator of the extrinsic coagulation pathway, but plasma TFPI levels in AP have not yet been determined.
  
  
  METHODS
  Plasma TFPI concentrations were measured by enzyme-linked immunosorbent assay in 44 patients with AP on admission. The relationships between AP severity, pancreatic necrosis, organ dysfunction, infection, and prognosis were analyzed.
  
  
  RESULTS
  Plasma TFPI levels were increased in AP patients compared with healthy volunteers. Plasma TFPI levels in severe AP were greater than those in mild AP. Plasma TFPI levels significantly correlated with Ranson score, APACHE II score, and Japanese severity score. Plasma TFPI levels in patients with pancreatic necrosis were greater than those in patients without pancreatic necrosis. Plasma TFPI levels in patients with organ dysfunction were greater than those in patients without organ dysfunction. In patients with pancreatic necrosis, the TF/TFPI ratios in non-survivors were lower than those in survivors. Moreover, the mortality rates in patients with TF/TFPI ratios > or = 2.0 were lower than those in patients with TF/TFPI ratios < 2.0.
  
  
  CONCLUSIONS
  Plasma TFPI levels were significantly increased in patients with AP, and the elevation was markedly related to the severity, pancreatic necrosis and organ dysfunctions. The imbalance of TF and TFPI may influence the disease state and thereby the prognosis in AP.
authors: Department of Surgery, Kinki University School of Medicine, 377-2 Ohno-higashi, Osaka-sayama 589-8511, Japan. yasudatk@surg.med.kindai.ac.jp
authors: Takeo
authors: T
authors: Yasuda
authors: Takashi
authors: T
authors: Ueda
authors: Keiko
authors: K
authors: Kamei
authors: Wataru
authors: W
authors: Shinzaki
authors: Hidehiro
authors: H
authors: Sawa
authors: Makoto
authors: M
authors: Shinzeki
authors: Yonson
authors: Y
authors: Ku
authors: Yoshifumi
authors: Y
authors: Takeyama
mesh_terms: D018806:APACHE; D000208:Acute Disease; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation / Q000502:physiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008074:Lipoproteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood / Q000401:mortality / Q000473:pathology; D009336:Necrosis; D010195:Pancreatitis / Q000097:blood* / Q000401:mortality / Q000473:pathology; D011379:Prognosis; D012720:Severity of Illness Index; D013925:Thromboplastin / Q000032:analysis / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D008074:Lipoproteins; C051928:lipoprotein-associated coagulation inhibitor; D013925:Thromboplastin