title: Dysregulation of inflammatory and hemostatic markers in sepsis and suspected disseminated intravascular coagulation.
abstract: Inflammatory mediators and hemostatic markers were evaluated in patients enrolled in a phase-2b study evaluating the safety and efficacy of recombinant thrombomodulin (ART-123) in patients with sepsis and suspected disseminated intravascular coagulation (DIC). In contrast to controls, patients with sepsis and suspected DIC showed an increase in the circulating levels of inflammatory and fibrinolytic markers. The levels of procalcitonin (PCT), interleukin 6 (IL-6), interleukin 10 (IL-10), anaphylatoxin C5a, plasminogen activator inhibitor 1 (PAI-1), and myeloperoxidase were higher in the patients with sepsis and suspected DIC, whereas protein C (PrC) exhibited a significant decrease. When the patients with overt and nonovert DIC were compared, the PrC level was lower, and PCT, PAI-1, IL-6, and IL-10 levels were higher in the patients with overt DIC. These results indicate that inflammation is elevated in sepsis and suspected DIC, and inflammation, impairment of fibrinolysis, and overconsumption of PrC may play a key role in the pathogenesis of DIC.
authors.affiliation: Research Laboratories, Loyola University Chicago, Maywood, IL, USA dhoppen@lumc.edu.
authors.forename: Debra
authors.initials: D
authors.lastname: Hoppensteadt
authors.affiliation: Asahi Kasei Pharma America Corporation, Waltham, MA, USA.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Tsuruta
authors.affiliation: Pacific Northwest Statistical Consulting, Inc, Woodinville, WA, USA.
authors.forename: Joe
authors.initials: J
authors.lastname: Hirman
authors.affiliation: Asahi Kasei Pharma America Corporation, Waltham, MA, USA.
authors.forename: Inder
authors.initials: I
authors.lastname: Kaul
authors.affiliation: Asahi Kasei Pharma America Corporation, Waltham, MA, USA.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Osawa
authors.affiliation: Research Laboratories, Loyola University Medical Center, Maywood, IL, USA.
authors.forename: Jawed
authors.initials: J
authors.lastname: Fareed
mesh_terms: D015415:Biomarkers / Q000097:blood; D004211:Disseminated Intravascular Coagulation / Q000097:blood*; D005260:Female; D005342:Fibrinolysis; D006490:Hemostatics / Q000097:blood*; D006801:Humans; D007249:Inflammation / Q000097:blood; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D018805:Sepsis / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006490:Hemostatics; D018836:Inflammation Mediators
keywords: disseminated intravascular coagulation; hypercoagulable; inflammation; sepsis-associated coagulopathy