Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2006, vol. 15, nr 2, March-April, p. 271–277

Publication type: original article

Language: English

Thrombomodulin in the Blood of Patients with Acute Cerebral Ischaemia

Trombomodulina we krwi chorych na ostre niedokrwienie mózgu

Krzysztof Widerkiewicz1,, Dorota Dzianott−Pabijan2,, Barbara Masłowska2,, Maria Kotschy3,

1 Merck Sharp & Dohme Idea Inc., Poland

2 Department of Neurology Dr J. Biziel Memorial Voivodship Hospital, Bydgoszcz, Poland

3 Chair and Division of Pathophysiology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Poland

Abstract

Background. Thrombomodulin (TM) is a membrane−bound receptor for thrombin expressed by vascular endothelial cells.
Objectives. Determination of the blood levels of soluble TM (sTM) in patients with acute cerebral ischaemia.
Material and Methods. The sample consisted of 73 patients (36 female, 37 male) aged 42–90 (68.1 ± 11.6) with acute cerebral ischaemia. sTM concentration was determined using the Imubind® Thrombomodulin ELISA Kit assay from American Diagnostica Inc.
Results. sTM concentration was found to be significantly higher in all patients with acute cerebral ischaemia enrolled in the study compared to the control group. There were no significant differences in sTM concentration among patients with acute cerebral ischaemia (ACI) relative to the presence of selected risk factors for ACI. A comparison of sTM concentration in patients with ACI relative to gender, age (below or above 70) and the presence or absence of a CT−confirmed ischaemic lesion did not reveal any statistically significant differences. Patients with ACI but without co−existing brain stem failure (ICT) had higher sTM levels. There were no differences in sTM concentration between patients with atherosclerotic and lacunar strokes or between patients with embolic strokes and transient ischaemic attacks. However, significantly lower sTM concentrations were seen in patients with embolic strokes or transient ischaemic attacks compared to patients with atherosclerotic or lacunar strokes.
Conclusion. Elevated sTM concentration is the result of vascular endothelial injury in the course of atherosclerosis in patients with acute cerebral ischaemia.

Streszczenie

Wprowadzenie. Trombomodulina (TM) jest receptorem błonowym dla trombiny obecnym na powierzchni komórek śródbłonka naczyń.
Cel pracy. Oznaczenie stężenia rozpuszczalnej TM (sTM) we krwi chorych z udarem niedokrwiennym mózgu.
Materiał i metody. Do badań włączono 73 chorych (36 kobiet i 37 mężczyzn) w wieku 42–90 lat (68,1 ± 11,6) z ostrym niedokrwieniem mózgu. Stężenie sTM oznaczano za pomocą testu Imubind® Thrombomodulin ELISA Kit firmy American Diagnostica Inc.
Wyniki. W całej analizowanej grupie chorych na ostre niedokrwienie mózgu stężenie sTM było istotnie większe niż w grupie kontrolnej. Nie stwierdzono istotnych statystycznie różnic stężenia sTM między chorymi na ostre niedokrwienie mózgu w zależności od występowania wybranych czynników ryzyka tej choroby. Porównując stężenie sTM u chorych na ostre niedokrwienie mózgu w zależności od płci, wieku > 70. lub < 70. r.ż. oraz od stwierdzanego w tomografii komputerowej ogniska niedokrwiennego, nie stwierdzono istotnych statystycznie różnic. U chorych na ostre niedokrwienie mózgu bez współistniejącej niedomogi pnia mózgu stwierdzono większe stężenia sTM. Nie stwierdzono różnic stężenia sTM między chorymi z udarem o etiologii miażdżycowej a lakunarnej oraz między chorymi z udarem o etiologii zatorowej a przemijającym niedokrwieniem mózgu. Zaobserwowano natomiast istotnie mniejsze stężenia sTM u chorych z udarem mózgu o etiologii zatorowej lub TIA w porównaniu z chorymi z udarem o etiologii miażdżycowej lub lakunarnej.
Wnioski. Zwiększone stężenie sTM jest wynikiem uszkodzenia śródbłonka naczyniowego przez proces miażdżycowy u chorych na ostre niedokrwienie mózgu.

Key words

soluble thrombomodulin, ischaemic stroke

Słowa kluczowe

rozpuszczalna trombomodulina, udar mózgowy

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