thromboplastin and Kidney-Diseases

The interaction of coagulation factors with the perivascular environment affects the development of disease in ways that extend beyond their traditional roles in the acute hemostatic cascade. Key molecular players of the coagulation cascade like tissue factor, thrombin, and fibrinogen are epidemiologically and mechanistically linked with diseases with an inflammatory component. Moreover, the identification of novel molecular mechanisms linking coagulation and inflammation has highlighted factors of the coagulation cascade as new targets for therapeutic intervention in a wide range of inflammatory human diseases. In particular, a proinflammatory role for fibrinogen has been reported in vascular wall disease, stroke, spinal cord injury, brain trauma, multiple sclerosis, Alzheimer's disease, rheumatoid arthritis, bacterial infection, colitis, lung and kidney fibrosis, Duchenne muscular dystrophy, and several types of cancer. Genetic and pharmacologic studies have unraveled pivotal roles for fibrinogen in determining the extent of local or systemic inflammation. As cellular and molecular mechanisms for fibrinogen functions in tissues are identified, the role of fibrinogen is evolving from a marker of vascular rapture to a multi-faceted signaling molecule with a wide spectrum of functions that can tip the balance between hemostasis and thrombosis, coagulation and fibrosis, protection from infection and extensive inflammation, and eventually life and death. This review will discuss some of the main molecular links between coagulation and inflammation and will focus on the role of fibrinogen in inflammatory disease highlighting its unique structural properties, cellular targets, and signal transduction pathways that make it a potent proinflammatory mediator and a potential therapeutic target.

Topics: Alzheimer Disease; Animals; Arthritis, Rheumatoid; Bacterial Infections; Blood Coagulation; Brain Injuries; Colitis; Fibrinogen; Humans; Inflammation; Kidney Diseases; Multiple Sclerosis; Muscular Dystrophy, Duchenne; Neoplasms; Pulmonary Fibrosis; Spinal Cord Injuries; Stroke; Thrombin; Thromboplastin; Vascular Diseases

Tissue factor (TF) is the main physiological initiator of blood coagulation and may be important in the biology of a variety of solid malignancies, particularly where angiogenesis is a critical factor. TF is frequently encrypted in the plasma membrane of cells in contact with blood, and is exposed only after stimulation by certain agonists. Cancer cells variably express TF and cancer cell lines which exhibit multidrug resistance contain more TF than parental cells. TF is increased in both tumour-associated macrophages and blood monocytes and has been implicated in abnormal coagulation activation seen in patients with inflammatory conditions and cancer. TF is also found in urine (uTF) in a lipid-associated form, probably of kidney origin. uTF levels can be assayed in a cost-effective manner and may be clinically important, particularly in patients with renal disorders and malignancy. uTF levels are not significantly affected by age, gender or cigarette smoking.

Topics: Age Factors; Biomarkers, Tumor; Blood Coagulation; Drug Resistance, Neoplasm; Enzyme-Linked Immunosorbent Assay; Humans; Kidney; Kidney Diseases; Kidney Neoplasms; Sex Factors; Thromboplastin

Topics: Animals; Fibrin; Humans; Kidney Diseases; Kidney Glomerulus; Thromboplastin

Abnormal expression of fibrinolytic genes [e.g., tissue-type and urokinase-type plasminogen activators (t-PA and u-PA) and their specific inhibitor (PAI-1)] and of the procoagulant molecule tissue factor (TF), has been reported in various types of renal diseases. In this review, the expression pattern of these genes was demonstrated in two murine models of renal disease. One is acute renal failure due to microthrombosis under septic conditions, using endotoxin-treated mice, and the other one is lupus nephritis observed in female MRL lpr/lpr mice. Quantitative reverse transcription-polymerase chain reaction analysis and in situ hybridization were employed to investigate the expression of their mRNAs in tissues from endotoxin-treated mice or from MRL lpr/lpr mice. A dramatic increase in PAI-1 activity in plasma and in PAI-1 mRNA in the kidneys was observed in both models, and this increase appeared to correlate with fibrin deposition in the renal microvasculature and with the progression of lupus nephritis. In addition to these changes in PAI-1, decreases in u-PA mRNA and increases in TF mRNA were demonstrated in the kidneys from lupus-prone mice as a function of age. Similar changes were also observed in the kidneys from endotoxin-treated mice. The induction of PAI-1 and TF, and the decrease in u-PA expression in the kidneys of lupus-prone or of endotoxemic mice may promote the formation of renal microthrombi and thus contribute to the progression of renal damage in these models.

Topics: Aging; Animals; Disease Models, Animal; Female; Fibrinolysis; Gene Expression Regulation; Humans; Kidney; Kidney Diseases; Mice; Plasminogen Activator Inhibitor 1; Thromboplastin; Urokinase-Type Plasminogen Activator

Topics: Animals; Basement Membrane; Blood Coagulation; Disease Models, Animal; Glomerulonephritis; Humans; Kidney Diseases; Kidney Glomerulus; Macrophages; Thromboplastin

Topics: Anticoagulants; Disseminated Intravascular Coagulation; Fetal Blood; Fibrin Fibrinogen Degradation Products; Fibrinolysis; Humans; Infant, Newborn; Kidney Diseases; Neoplasms; Thromboembolism; Thromboplastin

Hypercoagulability is associated with chronic kidney disease (CKD). Tissue factor/factor VIIa complex and factor Xa in the coagulation cascade are known to activate protease-activated receptor 2 (PAR2), and to cause inflammation and tissue injury. Although PAR2 is highly expressed in the kidney, it is unclear whether PAR2 plays a pathogenic role in CKD. To test this, we fed the mice lacking Par2 (F2rl1

Topics: Adenine; Animals; Enzyme-Linked Immunosorbent Assay; Factor V; Factor Xa; Fibrin; Fibrosis; Gene Expression Regulation; Inflammation; Kidney; Kidney Diseases; Male; Mice; Mice, Inbred C57BL; Mice, Transgenic; Oxidative Stress; Receptor, PAR-2; Renal Insufficiency, Chronic; Thromboplastin

Recombinant human soluble thrombomodulin (TM-α) was recently developed as an anticoagulant for patients with disseminated intravascular coagulation (DIC). However, the pharmacokinetics and pharmacodynamics of TM-α in DIC patients with severe renal impairment have not yet been elucidated. We investigated the pharmacokinetics and pharmacodynamics of TM-α in DIC patients with severe renal impairment. Eleven DIC patients with severe renal impairment (creatinine clearance <30 mL/min) and 10 DIC patients without severe renal impairment (creatinine clearance ≥30 mL/min) were included in this study. In all patients, a dose of 380 U/kg of TM-α was administered during a 30-min infusion. Blood samples were taken before the start of the first TM-α administration, and at 0.5, 2, 4, 8, and 24 h after the start of administration. Although the clearance of TM-α in the patients with renal impairment was 80% of that in the patients without renal impairment, none of the pharmacokinetic values were significantly different between the groups. In the pharmacokinetic simulation, however, the trough levels of TM-α increased gradually in the patients with renal impairment when the same dose of TM-α was repeatedly administered. After the administration of TM-α, the prothrombinase activities in the patients in both groups were sufficiently inhibited during the observation period. Although the pharmacokinetic values in DIC patients with severe renal impairment were only slightly different from those in DIC patients without severe renal impairment, we need to pay attention to the elevation of the trough levels of TM-α when the same dose of TM-α is repeatedly administered.

Topics: Aged; Anticoagulants; Disseminated Intravascular Coagulation; Female; Humans; Kidney Diseases; Male; Recombinant Proteins; Thrombomodulin; Thromboplastin

The abnormalities of tissue factor (TF) and its inhibitor (TFPI) system could potentially contribute to high incidence of thrombotic complications and atherosclerosis in patients with chronic kidney disease (CKD). Recently, the role of the kynurenine (KYN) pathway of tryptophan (TRP) degradation has been postulated in the progression of cardiovascular complications. We compared the plasma TF, TFPI and the metabolites of TRP degradation: KYN and 3-hydroxykynurenine (3-HKYN) levels in 55 CKD patients on conservative treatment and 19 healthy controls; and we tried to establish whether or not there is an association between TF/TFPI system and above-mentioned metabolites in these patients. Compared with the controls, the patients with CKD showed a significant increase in plasma concentrations of TF (P < 0.01), KYN, 3-HKYN (both P < 0.0001), KYN-to-TRP (kyn/trp) ratio (P < 0.001) and 3-HKYN-to-KYN (3-hkyn/kyn) ratio (P < 0.05). In contrast, TRP concentrations were significantly decreased in the CKD group compared with controls (P < 0.001). The difference in TFPI levels between CKD patients and controls was not statistically significant. TF/TFPI system was inversely correlated with TRP, whereas it was positively related to the 3-HKYN, kyn/trp and 3-hkyn/kyn ratios. Moreover, both the TF/TFPI system and KYNs were associated with the markers of kidney function. These data suggested for the first time a significant relationship between TF/TFPI system and KYN pathway in CKD patients on conservative treatment.

Topics: Adult; Aged; Case-Control Studies; Chronic Disease; Female; Humans; Kidney Diseases; Kynurenine; Lipoproteins; Male; Middle Aged; Thromboplastin; Tryptophan

To study baseline and stimulated tissue factor (TF) production from a normal, albeit immortalised, human kidney proximal tubular cell line (HKC-5), in order to establish a model for investigating the role of inflammatory mediators in the increased urinary TF (uTF) seen in inflammatory and neoplastic disease.. TF procoagulant activity, expression and secretion in HKC-5 cells were investigated using TF activity and antigen assays, fluorescence confocal microscopy and immunocytochemistry. TF expression in the HKC-5 cells was also studied using reverse transcription (RT)-PCR and its synthesis was suppressed using antisense oligodeoxynucleotide (ODN), directed against human TF mRNA. Cells were stimulated, after serum deprivation, with bacterial lipopolysaccharide (LPS), an agonist known to enhance TF expression in monocytes. They were also subject to serum starvation.. Analysis by RT-PCR showed TF production by stimulated and actively metabolising HKC-5 cells. Antisense ODN treatment resulted in approximately 50% suppression of TF synthesis compared to a mismatch ODN. The amount of TF produced by the HKC-5 cells was time dependent and coincides with a decrease in the intracellular TF levels. LPS up-regulated TF production in HKC-5 cells. Reducing fetal calf serum concentrations in the culture medium decreased TF production and secretion.. Stimulated TF synthesis and secretion in vitro by HKC-5 cells is consistent with the hypothesis that uTF is produced by tubular cells influenced by mediators of disease states and provides a model for further mechanistic investigations.

Topics: Cell Transformation, Viral; Culture Media; Dose-Response Relationship, Drug; Gene Expression; Humans; Immunoenzyme Techniques; Kidney Diseases; Kidney Tubules, Proximal; Lipopolysaccharides; Microscopy, Confocal; Models, Biological; Oligonucleotides, Antisense; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; Serum; Thromboplastin; Up-Regulation

1Alpha,25-dihydroxyvitamin D3 (active form of vitamin D3; vitamin D3) has been reported to induce the upregulation of thrombomodulin and downregulation of tissue factor (TF) on monocytes. The possibility exists that vitamin D3 prevents the development of disseminated intravascular coagulation (DIC). In particular, monocyte TF production plays an important role in the pathophysiology of DIC in septic patients. We have attempted to determine whether vitamin D3 is effective against DIC in a rat model induced by lipopolysaccharides (LPS) (30 mg/kg, 4 h) or TF (3.75 U/kg, 4 h) using selective hemostatic parameters, markers of organ dysfunction and pathological findings (assessment of glomelular fibrin deposition). Vitamin D3 was administered orally each day at a dose of 2.0 mg/kg/day for 3 days, or low molecular weight heparin (LMWH 200 u/kg; i.v.) was given 10 min before the injection of TF or LPS in each treatment group. Vitamin D3 was effective against DIC in the rat model induced by LPS only, whereas LMWH was effective against DIC in both rat models induced by either TF or LPS. The anti-DIC effect of vitamin D3 was equal to (or more potent than) that of LMWH. The results suggested that vitamin D3 was useful for the treatment of LPS-induced DIC, and that the assessment of a drug's efficacy should be done carefully given the markedly different results obtained according to the agents used to induce DIC.

Topics: Administration, Oral; Animals; Anticoagulants; Cholecalciferol; Coagulants; Disease Models, Animal; Disseminated Intravascular Coagulation; Fibrin; Heparin; Kidney Diseases; Kidney Glomerulus; Lipopolysaccharides; Male; Rats; Rats, Wistar; Sepsis; Thromboplastin; Thrombosis

Patients with late diabetic complications have increased levels of parameters indicating activation of coagulation (Takakashi et al., 1989; Ceriello, 1993; Murakami et al., 1993; Kario et al., 1995; Shimizu et al., 1995; Yokoyama et al., 1996), endothelial cell damage (Jensen, 1989; Iwashima et al., 1990; Sernau et al., 1995; Gabath et al., 1996). TF is believed to activate the coagulation mechanism in patients with late complications of diabetes. We studied the TF antigen plasma levels in 72 patients with diabetes mellitus (36 type I, 36 type II) with respect to its relevance as a marker of microvascular diabetic complications. TF levels did not correlate with macrovascular disease, diabetes type or age. Sixty patients with decreased renal function not due to diabetes were studied for evaluation of the contribution of renal failure to TF antigen plasma levels. We did not find a significant correlation of TF with s-creatinine in non diabetic patients (r = 0.27, p > 0.05). However, TF levels were elevated in diabetic patients with microvascular disease. Patients with retinopathy had higher TF levels than without (0.30 ng/ml vs 0.11 ng/ml, p < 0.007). When patients were divided into subgroups according to the urine albumin concentration, TF antigen of patients without albuminuria (0.019 ng/ml, n = 25) did not differ from patients with microalbuminuria (0.095 ng/ml, n = 19 p > 0.05). However, TF levels were significantly higher in patients with macroalbuminuria (n = 28; 0.215 ng/ml, p < 0.005). Thus activation of coagulation in patients with microvascular complications of diabetes may be triggered by tissue factor.

Topics: Adult; Aged; Albuminuria; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Diabetic Angiopathies; Diabetic Retinopathy; Enzyme-Linked Immunosorbent Assay; Female; Humans; Kidney Diseases; Male; Middle Aged; Thromboplastin

Topics: Biological Assay; Disseminated Intravascular Coagulation; Humans; Kidney Diseases; Radioimmunoassay; Reference Values; Specimen Handling; Spectrophotometry; Thromboplastin

Topics: Adult; Aged; Circadian Rhythm; Colorimetry; Female; Humans; Kidney Diseases; Male; Middle Aged; Oligopeptides; Thromboplastin

Topics: Chromogenic Compounds; Humans; Kidney Diseases; Oligopeptides; Spectrophotometry; Thromboplastin

During a period when screening for hepatitis B surface antigen (HBsAg) was performed by immunodiffusion using dextran-containing agarose gel, a diffuse precipitation (DP) zone was observed when citrate plasma samples were reacted with certain serum specimens. The DP reaction was noted with a significantly larger number of sera from patients with renal disorders, hepatitis, or certain other virus infections than with sera from apparently healthy blood donors, indicating that it was associated with some type of pathological condition. Highly purified fibrinogen used as detector reagent instead of plasma was sufficient to elicit a precipitation zone similar to that of the DP reaction. In the presence of coagulation inhibitors such as heparin, hirudin and antithrombin III the DP reaction was inhibited, suggesting that the precipitation zone represents coagulation. Cross-linked fibrin was demonstrated in the precipitates of DP-positive sera but not in the corresponding zone of a DP-negative serum.

Topics: Blood Coagulation; Factor X; Fibrin; Hepatitis; Humans; Immunodiffusion; Kidney Diseases; Thrombin; Thromboplastin

Circulating anticoagulants with antiprothrombinase activity were detected in 14 out of 49 patients (i.e. 29%) presenting with severe forms of systemic lupus erythematosus (SLE) predominantly renal (29) or extrarenal (20). Nine of these 14 patients had thrombopenia and 8 had a falsely positive Wassermann test. The anticoagulants were more frequently encountered in patients with severe extrarenal manifestations (9/20 cases) than in patients with severe proliferative renal lesions (5/29 cases). They were found in 5 out of 10 patients with arterial and/or venous thrombosis. Anticoagulant levels paralleled the course of the disease during treatment. No haemorrhage was observed in 14 percutaneous renal biopsies performed on 11 patients free from outer coagulopathies. This suggests that the presence of antiprothrombinase anticoagulants in the blood of patients without thrombopenia or other coagulation disorders is compatible with surgery or biopsy of the kidney.

Topics: Blood Coagulation; Female; Humans; Kidney Diseases; Lupus Erythematosus, Systemic; Male; Thromboplastin; Time Factors; Vascular Diseases

A study of human erythrocytes in healthy and sick persons showed changes in the erythrocytes procoagulant activity, namely a reduction of the whole cell thromboplastin activity despite a sufficient procoagulant factor content. A term "functional insufficiency of thromboplastin factor of erythrocytes" or briefly "erythrocytic thrombopathy" is suggested for the above-mentioned changes of erythrocytes, similar with the changes of platelet procoagulant properties in one of the thrombopathy forms.

Topics: Adolescent; Adult; Arteriosclerosis; Erythrocytes; Humans; Kidney Diseases; Middle Aged; Thromboplastin

Topics: Adolescent; Adult; Aged; Arteriosclerosis; Blood Coagulation; Erythrocytes; Female; Humans; Kidney Diseases; Male; Middle Aged; Thrombin; Thromboplastin

Topics: Blood Coagulation; Blood Platelets; Fibrinogen; Gold Colloid, Radioactive; Humans; Indium; Kidney Diseases; Liver Diseases; Mercury Isotopes; Platelet Adhesiveness; Prothrombin; Radiation Effects; Radioisotopes; Radionuclide Imaging; Thromboplastin; Time Factors

Topics: Arteriosclerosis; Chronic Disease; Erythrocytes; Fibrinogen; Glomerulonephritis; Humans; Kidney Diseases; Lipid Metabolism; Thromboplastin

Topics: Blood Coagulation Factors; Erythrocyte Count; Factor V; Factor VII; Factor X; Fibrinogen; Fibrinolysis; Gastrointestinal Diseases; Humans; Kidney Diseases; Liver Diseases; Lung Neoplasms; Lymph; Prothrombin; Prothrombin Time; Thoracic Duct; Thromboplastin

Topics: Adult; Beta-Globulins; Blood Coagulation Factors; Blood Coagulation Tests; Cellulose; Chromatography, Gel; Communicable Diseases; Electrophoresis; Erythrocytes; Escherichia coli; Female; Fibrinolytic Agents; Heart Failure; Hemostatics; Humans; Kidney Diseases; Leukocytes; Male; Middle Aged; Neoplasms; Proteus; Pseudomonas; Staphylococcus; Thromboplastin

Topics: Adolescent; Adult; Blood Coagulation Disorders; Hemorrhagic Fevers, Viral; Humans; Kidney Diseases; Middle Aged; Thromboplastin

Topics: Animals; Electrons; Female; Fibrin; Glomerulonephritis; Humans; Kidney Diseases; Kidney Glomerulus; Microscopy; Microscopy, Electron; Pathology; Phagocytosis; Pre-Eclampsia; Pregnancy; Rabbits; Research; Sepsis; Thromboplastin

Topics: Aminocaproates; Aminocaproic Acid; Animals; Anticoagulants; Electrons; Fibrin; Kidney Diseases; Kidney Glomerulus; Necrosis; Nephrosclerosis; Pathology; Rabbits; Research; Thrombin; Thromboplastin; Thrombosis

Topics: Animals; Blood Coagulation; Blood Coagulation Factors; Blood Coagulation Tests; Cholesterol; Factor V; Factor VII; Factor X; Fibrinogen; Kidney Diseases; Kidney Function Tests; Nephritis; Nitrogen; Pathology; Prothrombin; Pyelonephritis; Rabbits; Rats; Research; Thromboplastin

Topics: Anemia; Blood Coagulation; Blood Coagulation Factors; Blood Coagulation Tests; Blood Platelets; Calcium; Factor IX; Factor V; Factor VII; Factor VIII; Factor X; Factor XI; Factor XII; Fibrinogen; Hemolysis; Humans; Kidney Diseases; Liver Diseases; Prothrombin; Thromboplastin

Topics: Animal Experimentation; Animals; Coagulants; Factor Xa; Fibrinogen; Hemostatics; Kidney; Kidney Diseases; Thromboplastin

Topics: Humans; Kidney Diseases; Pancreatic Neoplasms; Thromboplastin