Thrombin Generation Mediators and Markers in Sepsis Associated Coagulapathy,

Abstract 3341

Thrombin plays a crucial role in the pathogenesis of sepsis associated disseminated intravascular coagulation (DIC). The purpose of this study was to profile prothrombin fragment (F1.2), fibrinopeptide A (FPA) and thrombin antithrombin complex (TAT), along with tissue factor (TF), microparticles (MP), D-dimer (DD) and antithrombin (AT). Baseline plasma samples from one hundred patients diagnosed with sepsis associated DIC were analyzed for various parameters by using ELISA methods. The MP levels were measured by using a functional method utilizing annexing trapping whereas the antithrombin was measured using both the functional and immunologic methods. Plasma samples from 50 normal male and female individuals comprised the control group. The results are tabulated in the following table. Both TF and MP levels were markedly elevated in comparison to the control group. All of the other markers of thrombin generation showed elevated levels F1.2 (3.4 fold), FPA (4.3 fold) and TAT (4.0 fold). Marked elevation of D-dimer was also noted (5.0 fold). Both the immunologic and functional levels of AT were also decreased. While the data was widely scattered, these results show that DIC represents a hypercoagulable state along with other hemostatic abnormalities and the activation of the inflammatory process. Modulation of these activation processes such as the antithrombin, thrombomodulin and TFPI may play an important regulatory role in the pathogenesis of this syndrome.