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Usefulness of circulating vascular endothelial growth factor and neutrophil elastase as diagnostic markers of disseminated intravascular coagulation in non-cancer patients.

Joo SY, Kim JE, Kim JY, Han KS, Kim HK - Korean J Hematol (2010)

Bottom Line: However, the circulating endostatin level did not change significantly according to the DIC score.We divided the patients into 2 groups: the non-cancer and cancer patient groups, to exclude the VEGF release from tumor tissues.They are expected to be potential diagnostic markers of overt DIC, especially in non-cancer patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

Background: Disseminated intravascular coagulation (DIC) is characterized by platelet and neutrophil activation. Platelets are the major source of circulating vascular endothelial growth factor (VEGF). Endostatin, an anti-angiogenic factor, is a fragment of collagen that is released from the extracellular matrix via the active cleavage of neutrophil elastase, thereby increasing the circulating level of endostatin. Hypercoagulable conditions such as DIC may induce the release of VEGF and neutrophil elastase from the platelets and neutrophils.

Methods: We enrolled 240 patients who were clinically suspected of having DIC. Plasma levels of VEGF, endostatin, and neutrophil elastase were determined using commercial ELISA kits. Patients were diagnosed as having overt DIC if the cumulative International Society on Thrombosis and Haemostasis Subcommittee score was >5.

Results: Overt DIC was diagnosed in 80 of the 240 patients. The circulating VEGF and neutrophil elastase levels gradually increased according to the severity of coagulopathy, as reflected by the DIC score. However, the circulating endostatin level did not change significantly according to the DIC score. We divided the patients into 2 groups: the non-cancer and cancer patient groups, to exclude the VEGF release from tumor tissues. Interestingly, in non-cancer patients, higher VEGF and neutrophil elastase levels were found to be significant diagnostic markers for overt DIC.

Conclusion: Our findings suggest that circulating VEGF and neutrophil elastase levels are laboratory markers reflecting coagulation activity. They are expected to be potential diagnostic markers of overt DIC, especially in non-cancer patients.

No MeSH data available.


Related in: MedlinePlus

Plasma VEGF, endostatin, and elastase levels based on the DIC score in total (A), cancer (B), and non-cancer (C) patients. The upper and lower limits of each box represent the value of 25 and 75 percentile, respectively, and the bar represents the range of the levels of analyte. DIC groups I, II, and III included the patients with DIC score of 0-3, 4-5, and 6 or more, respectively. a)P<0.05, b)P<0.001. VEGF, vascular endothelial growth factor; DIC, disseminated intravascular coagulation.
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Figure 1: Plasma VEGF, endostatin, and elastase levels based on the DIC score in total (A), cancer (B), and non-cancer (C) patients. The upper and lower limits of each box represent the value of 25 and 75 percentile, respectively, and the bar represents the range of the levels of analyte. DIC groups I, II, and III included the patients with DIC score of 0-3, 4-5, and 6 or more, respectively. a)P<0.05, b)P<0.001. VEGF, vascular endothelial growth factor; DIC, disseminated intravascular coagulation.

Mentions: To determine whether the levels of VEGF, endostatin, and neutrophil elastase correlated with coagulopathy, we divided the patients into 3 groups according to the DIC score. In all the patients, the serum level of VEGF increased as the DIC score increased (Fig. 1A). Because cancer tissues might show increased VEGF secretion, we separated non-cancer patients from cancer patients. Both in cancer and non-cancer patients, the level of VEGF correlated with the degree of coagulopathy (Fig. 1B, C). Similarly, the level of neutrophil elastase increased according to the DIC scores in all, cancer, and non-cancer patients. On the other hand, the level of endostatin showed no significant difference according to the DIC scores.


Usefulness of circulating vascular endothelial growth factor and neutrophil elastase as diagnostic markers of disseminated intravascular coagulation in non-cancer patients.

Joo SY, Kim JE, Kim JY, Han KS, Kim HK - Korean J Hematol (2010)

Plasma VEGF, endostatin, and elastase levels based on the DIC score in total (A), cancer (B), and non-cancer (C) patients. The upper and lower limits of each box represent the value of 25 and 75 percentile, respectively, and the bar represents the range of the levels of analyte. DIC groups I, II, and III included the patients with DIC score of 0-3, 4-5, and 6 or more, respectively. a)P<0.05, b)P<0.001. VEGF, vascular endothelial growth factor; DIC, disseminated intravascular coagulation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2983001&req=5

Figure 1: Plasma VEGF, endostatin, and elastase levels based on the DIC score in total (A), cancer (B), and non-cancer (C) patients. The upper and lower limits of each box represent the value of 25 and 75 percentile, respectively, and the bar represents the range of the levels of analyte. DIC groups I, II, and III included the patients with DIC score of 0-3, 4-5, and 6 or more, respectively. a)P<0.05, b)P<0.001. VEGF, vascular endothelial growth factor; DIC, disseminated intravascular coagulation.
Mentions: To determine whether the levels of VEGF, endostatin, and neutrophil elastase correlated with coagulopathy, we divided the patients into 3 groups according to the DIC score. In all the patients, the serum level of VEGF increased as the DIC score increased (Fig. 1A). Because cancer tissues might show increased VEGF secretion, we separated non-cancer patients from cancer patients. Both in cancer and non-cancer patients, the level of VEGF correlated with the degree of coagulopathy (Fig. 1B, C). Similarly, the level of neutrophil elastase increased according to the DIC scores in all, cancer, and non-cancer patients. On the other hand, the level of endostatin showed no significant difference according to the DIC scores.

Bottom Line: However, the circulating endostatin level did not change significantly according to the DIC score.We divided the patients into 2 groups: the non-cancer and cancer patient groups, to exclude the VEGF release from tumor tissues.They are expected to be potential diagnostic markers of overt DIC, especially in non-cancer patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

Background: Disseminated intravascular coagulation (DIC) is characterized by platelet and neutrophil activation. Platelets are the major source of circulating vascular endothelial growth factor (VEGF). Endostatin, an anti-angiogenic factor, is a fragment of collagen that is released from the extracellular matrix via the active cleavage of neutrophil elastase, thereby increasing the circulating level of endostatin. Hypercoagulable conditions such as DIC may induce the release of VEGF and neutrophil elastase from the platelets and neutrophils.

Methods: We enrolled 240 patients who were clinically suspected of having DIC. Plasma levels of VEGF, endostatin, and neutrophil elastase were determined using commercial ELISA kits. Patients were diagnosed as having overt DIC if the cumulative International Society on Thrombosis and Haemostasis Subcommittee score was >5.

Results: Overt DIC was diagnosed in 80 of the 240 patients. The circulating VEGF and neutrophil elastase levels gradually increased according to the severity of coagulopathy, as reflected by the DIC score. However, the circulating endostatin level did not change significantly according to the DIC score. We divided the patients into 2 groups: the non-cancer and cancer patient groups, to exclude the VEGF release from tumor tissues. Interestingly, in non-cancer patients, higher VEGF and neutrophil elastase levels were found to be significant diagnostic markers for overt DIC.

Conclusion: Our findings suggest that circulating VEGF and neutrophil elastase levels are laboratory markers reflecting coagulation activity. They are expected to be potential diagnostic markers of overt DIC, especially in non-cancer patients.

No MeSH data available.


Related in: MedlinePlus