Volume 18 Issue 4
Aug.  2005
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ZHONG-HUA LIU, RAN WEI, YA-PING WU, TON LISMAN, ZENG-XIAN WANG, JI-JU HAN, DAO-LING REN, BIN CHEN, ZUO-LI XIA, BIAO CHEN, ZHEN ZHU, YAN ZHANG, XING CUI, HAI-TAO HU, PHILIP G. DE GROOT, WEN-BO XU. Elevated Plasma Tissue-type Plasminogen Activator (t-PA) and Soluble Throm-bomodulin in Patients Suffering From Severe Acute Respiratory Syndrome (SARS) as a Possible Index for Prognosis and Treatment Strategy[J]. Biomedical and Environmental Sciences, 2005, 18(4): 260-264.
Citation: ZHONG-HUA LIU, RAN WEI, YA-PING WU, TON LISMAN, ZENG-XIAN WANG, JI-JU HAN, DAO-LING REN, BIN CHEN, ZUO-LI XIA, BIAO CHEN, ZHEN ZHU, YAN ZHANG, XING CUI, HAI-TAO HU, PHILIP G. DE GROOT, WEN-BO XU. Elevated Plasma Tissue-type Plasminogen Activator (t-PA) and Soluble Throm-bomodulin in Patients Suffering From Severe Acute Respiratory Syndrome (SARS) as a Possible Index for Prognosis and Treatment Strategy[J]. Biomedical and Environmental Sciences, 2005, 18(4): 260-264.

Elevated Plasma Tissue-type Plasminogen Activator (t-PA) and Soluble Throm-bomodulin in Patients Suffering From Severe Acute Respiratory Syndrome (SARS) as a Possible Index for Prognosis and Treatment Strategy

Funds:  国家自然科学基金(grant 30300395)%山东省自然科学基金(grant Y2003C01)%The Dutch Thrombosis Foundation(grant 20023)
  • Objective To detect the presence of endothelial injury in patients with severe acute respiratory syndrome (SARS) via enhanced levels of tissue-type plasminogen activator (t-PA) and soluble thrombomodulin (sTM). Methods Case patients were from Xuanwu Hospital (Capital University of Medical Sciences, Beijing, China), and all of them met clinical criteria for SARS. Healthy controls were some of the hospital employees. Endothelial injury bio-markers tPA and sTM were detected by commercial ELISA-methods. Results Classic plasma markers of endothelial injury, tPA and sTM significantly elevated in SARS patients in comparison to controls [t-PA: 1.48±0.16 nmol/L versus 0.25±0.03 nmol/L (P<0.0001), and sTM: 0.26±0.06 nmol/L versus 0.14±0.02 nmol/L (P<0.05)]. The only patient who died had extremely high levels of these endothelial injury markers (t-PA: 2.77 nmol/L and sTM: 1.01 nmol/L). The likelihood ratio analysis indicated the excellent discriminating power for SARS at the optimal cut-point of 0.49 nmol/L for tPA and 0.20 nmol/L for sTM, respectively. Significant numerical correlations were found among these endothelial injury markers in SARS patients. The numerical coefficient of correlation Pearson r between t-PA and sTM was 0.5867 (P<0.05). Conclusion Increased plasma concentrations of tPA and sTM in patients with SARS suggest the possibility of endothelial injury. SARS patients might need anticoagulant therapy or fibrinolytic therapy in order to reverse intraalveolar coagulation, microthrombi formation, alveolar and interstitial fibrin deposition. It may not only provide a useful treatment and prognostic index but also allow a further understanding of the pathological condition of the disease.
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Elevated Plasma Tissue-type Plasminogen Activator (t-PA) and Soluble Throm-bomodulin in Patients Suffering From Severe Acute Respiratory Syndrome (SARS) as a Possible Index for Prognosis and Treatment Strategy

Funds:  国家自然科学基金(grant 30300395)%山东省自然科学基金(grant Y2003C01)%The Dutch Thrombosis Foundation(grant 20023)

Abstract: Objective To detect the presence of endothelial injury in patients with severe acute respiratory syndrome (SARS) via enhanced levels of tissue-type plasminogen activator (t-PA) and soluble thrombomodulin (sTM). Methods Case patients were from Xuanwu Hospital (Capital University of Medical Sciences, Beijing, China), and all of them met clinical criteria for SARS. Healthy controls were some of the hospital employees. Endothelial injury bio-markers tPA and sTM were detected by commercial ELISA-methods. Results Classic plasma markers of endothelial injury, tPA and sTM significantly elevated in SARS patients in comparison to controls [t-PA: 1.48±0.16 nmol/L versus 0.25±0.03 nmol/L (P<0.0001), and sTM: 0.26±0.06 nmol/L versus 0.14±0.02 nmol/L (P<0.05)]. The only patient who died had extremely high levels of these endothelial injury markers (t-PA: 2.77 nmol/L and sTM: 1.01 nmol/L). The likelihood ratio analysis indicated the excellent discriminating power for SARS at the optimal cut-point of 0.49 nmol/L for tPA and 0.20 nmol/L for sTM, respectively. Significant numerical correlations were found among these endothelial injury markers in SARS patients. The numerical coefficient of correlation Pearson r between t-PA and sTM was 0.5867 (P<0.05). Conclusion Increased plasma concentrations of tPA and sTM in patients with SARS suggest the possibility of endothelial injury. SARS patients might need anticoagulant therapy or fibrinolytic therapy in order to reverse intraalveolar coagulation, microthrombi formation, alveolar and interstitial fibrin deposition. It may not only provide a useful treatment and prognostic index but also allow a further understanding of the pathological condition of the disease.

ZHONG-HUA LIU, RAN WEI, YA-PING WU, TON LISMAN, ZENG-XIAN WANG, JI-JU HAN, DAO-LING REN, BIN CHEN, ZUO-LI XIA, BIAO CHEN, ZHEN ZHU, YAN ZHANG, XING CUI, HAI-TAO HU, PHILIP G. DE GROOT, WEN-BO XU. Elevated Plasma Tissue-type Plasminogen Activator (t-PA) and Soluble Throm-bomodulin in Patients Suffering From Severe Acute Respiratory Syndrome (SARS) as a Possible Index for Prognosis and Treatment Strategy[J]. Biomedical and Environmental Sciences, 2005, 18(4): 260-264.
Citation: ZHONG-HUA LIU, RAN WEI, YA-PING WU, TON LISMAN, ZENG-XIAN WANG, JI-JU HAN, DAO-LING REN, BIN CHEN, ZUO-LI XIA, BIAO CHEN, ZHEN ZHU, YAN ZHANG, XING CUI, HAI-TAO HU, PHILIP G. DE GROOT, WEN-BO XU. Elevated Plasma Tissue-type Plasminogen Activator (t-PA) and Soluble Throm-bomodulin in Patients Suffering From Severe Acute Respiratory Syndrome (SARS) as a Possible Index for Prognosis and Treatment Strategy[J]. Biomedical and Environmental Sciences, 2005, 18(4): 260-264.

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