tailieunhanh - Báo cáo y học: "Thrombomodulin phenotype of a distinct monocyte subtype is an independent prognostic marker for disseminated intravascular coagulation"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Thrombomodulin phenotype of a distinct monocyte subtype is an independent prognostic marker for disseminated intravascular coagulation. | Hwang et al. Critical Care 2011 15 R113 http content 15 2 R113 KS CRITICAL CARE RESEARCH Open Access Thrombomodulin phenotype of a distinct monocyte subtype is an independent prognostic marker for disseminated intravascular coagulation Sang Mee Hwang1 2t Ji-Eun Kim1 2t Kyou-Sup Han1 2 and Hyun Kyung Kim1 2 Abstract Introduction Thrombomodulin which is expressed solely on monocytes along with tissue factor TF takes part in coagulation and inflammation. Circulating blood monocytes can be divided into 3 major subtypes on the basis of their receptor phenotype classical CD14brightCD16negative CMs inflammatory CD14brightCD16positive IMs and dendritic cell-like CD14dimCD16positive DMs . Monocyte subtype is strongly regulated and the balance may influence the clinical outcomes of disseminated intravascular coagulation DIC . Therefore we investigated the phenotypic difference in thrombomodulin and TF expression between different monocyte subtypes in coagulopathy severity and prognosis in patients suspected of having DIC. Methods In total 98 patients suspected of having DIC were enrolled. The subtypes of circulating monocytes were identified using CD14 and CD16 and the thrombomodulin and TF expression in each subtype expressed as mean fluorescence intensity was measured by flow cytometry. Plasma level of tissue factor was measured by ELISA. In cultures of microbead-selected CD14-positive peripheral monocytes lipopolysaccharide LPS - or interleukin-10-induced expression profiles were analyzed using flow cytometry. Results The proportion of monocyte subtypes did not significantly differ between the overt and non-overt DIC groups. The IM thrombomodulin expression level was prominent in the overt DIC group and was well correlated with other coagulation markers. Of note IM thrombomodulin expression was found to be an independent prognostic marker in multivariate Cox regression analysis. In addition in vitro culture of peripheral monocytes showed that LPS stimulation .