Activation of Blood Coagulation and Fibrinolysis in Selected Disease States Assessed by Plasma Levels of Thrombin-Antithrombin III Complex and Plasmin-α2-Plasmin Inhibitor Complex

Abstract

Plasma levels of thrombin-antithrombin III complex (TAT) and plasmin-α2-plasmin inhibitor complex (PAP) were measured by enzyme-linked immunosorbent assays (ELISA) together with other coagulation parameters in patients with hematological diseases, liver diseases, diabetes mellitus, systemic lupus erythematosus, thrombotic diseases and disseminated intravascular coagulation (DIC). The mean plasma levels of TAT and PAP in 28 healthy subjects were 1.26±SD 0.71ng/ml and 0.22±0.14μg/ml, respectively. Both TAT and PAP were elevated in a variety of diseases, especially in DIC (22.97±19.66ng/ml and 4.33±3.08μg/ml, respectively), followed by liver diseases, thrombotic diseases and hematological malignancies. On the whole, the PAP value was correlated with TAT (r=0.533, p<0.00001). Plasma concentrations of TAT and PAP were correlated positively with concurrently assayed prothrombin time, FDP and von Willebrand factor antigen/factor VIII activity ratio, and negatively with fibrinogen, α2-plasmin inhibitor, plasminogen and ristocetin cofactor/von Willebrand factor antigen ratio. No correlation was found between TAT and antithrombin III. These findings indicate that excessive amounts of thrombin and plasmin are actually generated not only in DIC patients but also in patients with a variety of diseases. In addition, measurements of TAT and PAP in plasma would be sensitive parameters for specific detection of activation of blood coagulation and fibrinolysis in selected disease states.