Examination of biomarker expressions in sepsis-related DIC patients

Figures & data

Table 1 Demographic and clinical characteristics of the patients and controls

Group	Patients			Control
	Sepsis with DIC	Sepsis without DIC	HM with DIC	Healthy persons
n	18	7	15	12
Age/years	67.5	63.6	70.1	65
Sex, male/female	7/11	3/4	11/4	7/5
APACHE II score	21.5**	13.6	–	–
SOFA score	10.8*	7.4	–	–
DIC score	6.0 (JAAM)**	2.0 (JAAM)	6.0 (JMHW)	–
PT-INR	1.41±0.11	1.31±0.09	1.35±0.08	1.04±0.01
ATIII (%)	57.5±4.7*	68.2±5.3	71.3±4.6	82.5±3.1
FDP (μg/mL)	41.2±9.2*	26.2±5.1	23.4±4.9	7.2±1.1
D-dim (μg/mL)	13.9±2.2**	4.4±0.6	11.9±2.3	1.3±0.2
Fbg (mg/mL)	262±24	305±31	241±19	286±15
Plt (×10^4/μL)	7.3±2.1	11.4±3.3	3.9±1.6	15.2±3.5

Notes: Between-group comparisons were analyzed using the Newman–Keuls and Scheffe’s tests. Data are shown as mean ± SD.

* P<0.05;

** P<0.01.

Abbreviations: ATIII, antithrombin III; APACHE II, Acute Physiology and Chronic Health Evaluation II; D-dim, D-dimer; DIC, disseminated intravascular coagulation; Fbg, fibrinogen; FDP, fibrin/fibrinogen degradation products; HM, hematological malignancy; JAAM, Japanese Association for Acute Medicine; JMHW, Japanese Ministry of Health and Welfare; Plt, platelet; PT-INR, prothrombin time-international normalized ratio; SOFA, Sequential Organ Failure Assessment.

Table 2 Comparison of PDMPs, cytokines, and soluble factors between the patients and controls

Group	Patients			Controls
	Sepsis with DIC	Sepsis without DIC	HM with DIC	Healthy persons
n	18	7	15	12
PDMP (U/mL)	26.8±10.2^*^Citation1	19.4±7.5	15.3±7.4	9.5±2.1
IL-6 (pg/mL)	559±284^*^Citation2	312±105^*^Citation1	105±24	6.8±1.2
TPO (pg/mL)	1,866±237^*^Citation2	1,244±107^*^Citation1	425±41	366±39
HMGB1 (ng/mL)	35.2±19.8	23.6±11.4	35.9±20.2	7.3±2.5
sVCAM-1 (pg/mL)	1,632±508	1,586±420	1,950±411	788±196
sP-selectin (pg/mL)	285±75^*^Citation1	277±96^*^Citation1	214±42	183±26
sE-selectin (pg/mL)	141±76	132±41	145±39	56±12
sL-selectin (pg/mL)	2,015±622	1,865±513	1,980±496	720±217

Notes: Between-group comparisons were analyzed using the Newman–Keuls and Scheffe’s tests. Data are shown as mean ± SD.

Abbreviations: DIC, disseminated intravascular coagulation; IL-6, interleukin-6; HM, hematological malignancy; HMGB1, high-mobility group box 1; PDMP, platelet-derived microparticle; sE-selectin, soluble E-selectin; sL-selectin, soluble L-selectin; sP-selectin, soluble P-selectin; sVCAM-1, soluble vascular cell adhesion molecule-1; TPO, thrombopoietin.

Table 3 Correlations of PDMPs and sP-selectin with cytokines in sepsis and HM patients with DIC

Cytokines	PDMP		sP-selectin
	R	P-value	R	P-value
Sepsis with DIC
IL-6 (pg/mL)	0.501	0.010	0.433	0.037
TPO (pg/mL)	0.454	0.012	0.474	0.009
HM with DIC
IL-6 (pg/mL)	0.245	0.291	0.247	0.234
TPO (pg/mL)	0.316	0.108	0.217	0.312

Note: Correlations were assessed with Spearman’s rank correlation test.

Abbreviations: DIC, disseminated intravascular coagulation; HM, hematological malignancy; IL-6, interleukin-6; PDMP, platelet-derived microparticle; sP-selectin, soluble P-selectin; TPO, thrombopoietin.

Figure 1 Plasma concentrations of PDMPs, HMGB1, IL-6, and TPO before and after ATIII or rTM treatment of DIC patients.

Notes: Between-group comparisons were analyzed using the Newman–Keuls and Scheffe’s tests. Bars show the mean ± SD. 0: before; d: day (after), P-values are for comparison with each baseline parameter (0 vs 7 days, 14 days, and 21 days).
Abbreviations: ATIII, antithrombin III; DIC, disseminated intravascular coagulation; HM, hematologic malignancy; HMGB1, high mobility group box 1; IL-6, interleukin-6; NS, not significant; PDMP, platelet-derived microparticle; rTM, recombinant thrombomodulin; TPO, thrombopoietin.

Figure 2 Plasma concentrations of sP-selectin, sE-selectin, sL-selectin, and sVCAM-1 before and after ATIII or rTM treatment of DIC patients.

Notes: Between-group comparisons were analyzed using the Newman–Keuls and Scheffe’s tests. Bars show the mean ± SD. 0: before; d: day (after), P-values are for comparison with each baseline parameter (0 vs 7 days, 14 days, and 21 days).
Abbreviations: ATIII, antithrombin III; DIC, disseminated intravascular coagulation; HM, hematologic malignancy; NS, not significant; rTM, recombinant thrombomodulin; sP-selectin, soluble P-selectin; sE-selectin, soluble E-selectin; sL-selectin, soluble L-selectin; sVCAM-1, soluble vascular cell adhesion molecule-1.

Figure 3 Study of platelet activation by agonists and cytokines.

Notes: Between-group comparisons were analyzed using the Newman–Keuls and Scheffe’s tests. Bars show the mean ± SD. These biomarkers were equally distributed. *P-values are for comparison with each baseline parameter (Ag (−) vs Ag (+)). **P-values are for comparison between 2 parameters (Ag (+) and cytokine (−) vs Ag (+) and IL-6 or TPO).
Abbreviations: Ag, agonist; PDMP, platelet-derived microparticle; sCD40L, soluble CD40 ligand; IL-6, interleukin-6; TPO, thrombopoietin.

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