Thrombomodulin phenotype of a distinct monocyte subtype is an independent prognostic marker for disseminated intravascular coagulation 英文参考文献.docVIP

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Thrombomodulin phenotype of a distinct monocyte subtype is an independent prognostic marker for disseminated intravascular coagulation 英文参考文献.doc

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Thrombomodulin phenotype of a distinct monocyte subtype is an independent prognostic marker for disseminated intravascular coagulation 英文参考文献

Hwangetal.CriticalCare2011,15:R113 /content/15/2/R113 RESEARCH OpenAccess Thrombomodulinphenotypeofadistinct monocytesubtypeisanindependentprognostic markerfordisseminatedintravascularcoagulation SangMeeHwang1,2?,Ji-EunKim1,2?,Kyou-SupHan1,2 andHyunKyungKim1,2* Abstract Introduction:Thrombomodulin,whichisexpressedsolelyonmonocytes,alongwithtissuefactor(TF),takespart incoagulationandinflammation.Circulatingbloodmonocytescanbedividedinto3majorsubtypesonthebasis oftheirreceptorphenotype:classical(CD14brightCD16negative,CMs),inflammatory(CD14brightCD16positive;IMs),and dendriticcell-like(CD14dimCD16positive DMs).Monocytesubtypeisstronglyregulated,andthebalancemay influencetheclinicaloutcomesofdisseminatedintravascularcoagulation(DIC).Therefore,weinvestigatedthe phenotypicdifferenceinthrombomodulinandTFexpressionbetweendifferentmonocytesubtypesin coagulopathyseverityandprognosisinpatientssuspectedofhavingDIC. Methods:Intotal,98patientssuspectedofhavingDICwereenrolled.Thesubtypesofcirculatingmonocyteswere identifiedusingCD14andCD16andthethrombomodulinandTFexpressionineachsubtype,expressedasmean fluorescenceintensity,wasmeasuredbyflowcytometry.PlasmaleveloftissuefactorwasmeasuredbyELISA.In culturesofmicrobead-selected,CD14-positiveperipheralmonocytes,lipopolysaccharide(LPS)-orinterleukin-10- inducedexpressionprofileswereanalyzed,usingflowcytometry. Results:Theproportionofmonocytesubtypesdidnotsignificantlydifferbetweentheovertandnon-overtDIC groups.TheIMthrombomodulinexpressionlevelwasprominentintheovertDICgroupandwaswellcorrelated withothercoagulationmarkers.Ofnote,IMthrombomodulinexpressionwasfoundtobeanindependent prognosticmarkerinmultivariateCoxregressionanalysis.Inaddition,invitrocultureofperipheralmonocytes showedthatLPSstimulationupregulatedthrombomodulinexpressionandTFexpressionindistinctpopulationsof monocytes. Conclusions:ThesefindingssuggestthattheIMthrombomodulinphenotypeisapotentialindependent prognosticmarkerforDIC,andthatthrombomodulin-inducedupregula