Elevated plasma CL-K1 level is associated with a risk of developing disseminated intravascular coagulation (DIC).
Collectin kidney 1 (CL-K1) is a recently identified collectin that is synthesized in most organs and circulates in blood. CL-K1 is an innate immune molecule that may play a significant role in host defense. As some collectins also play a role in coagulation, we hypothesized that an effect of CL-K1 may be apparent in disseminated intravascular coagulation (DIC), a gross derangement of the coagulation system that occurs in the setting of profound activation of the innate immune system. DIC is a grave medical condition with a high incidence of multiple organ failure and high mortality and yet there are no reliable biomarkers or risk factors. In our present study, we measured plasma CL-K1 concentration in a total of 659 specimens, including 549 DIC patients, 82 non-DIC patients and 27 healthy volunteers. The median plasma CL-K1 levels in these cohorts were 424, 238 and 245 ng/ml, respectively, with no significant difference in the latter two groups. The incidence of elevated plasma CL-K1 was significantly higher in the DIC patients compared to the non-DIC patients, resulting in an odds ratio of 1.929 (confidence interval 1.041-3.866). Infection, renal diseases, respiratory diseases, and cardiac diseases were more frequently observed in the DIC group than in the non-DIC group. In the DIC group, vascular diseases were associated with elevated plasma CL-K1 levels while age and acute illness had little effect on plasma CL-K1 levels. Independent of DIC, elevated plasma CL-K1 levels were associated with respiratory disease and coagulation disorders. These results suggest that specific diseases may affect CL-K1 synthesis in an organ dependent manner and that elevated plasma CL-K1 levels are associated with the presence of DIC. Further investigations in cohorts of patients are warranted. We propose that elevated plasma CL-K1 may be a new useful risk factor and possibly biomarker for the prediction of developing DIC.
Department of Pediatrics, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA, ktakahashi1@gmail.com.
Kazue
K
Takahashi
Katsuki
K
Ohtani
Mykol
M
Larvie
Patience
P
Moyo
Lorencia
L
Chigweshe
Elizabeth M
EM
Van Cott
Nobutaka
N
Wakamiya
D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001778:Blood Coagulation Disorders / Q000097:blood; D015331:Cohort Studies; D037222:Collectins / Q000097:blood*; D004211:Disseminated Intravascular Coagulation / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012140:Respiratory Tract Diseases / Q000097:blood; D012307:Risk Factors
D015415:Biomarkers; C518521:Colec11 protein, human; D037222:Collectins