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Gewählte Publikation:

Cvirn, G; Gallistl, S; Rehak, T; Jürgens, G; Muntean, W.
Elevated thrombin-forming capacity of tissue factor-activated cord compared with adult plasma.
J THROMB HAEMOST. 2003; 1(8): 1785-1790. Doi: 10.1046%2Fj.1538-7836.2003.00320.x [OPEN ACCESS]
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Führende Autor*innen der Med Uni Graz
Cvirn Gerhard
Co-Autor*innen der Med Uni Graz
Gallistl Siegfried
Jürgens Günther
Muntean Eugen
Rehak Thomas
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Abstract:
Clinically observed excellent hemostasis in neonates despite low levels of clotting factors is not completely understood so far. Therefore, we investigated whether physiological low levels of the inhibitor protein C (PC) facilitate thrombin formation in tissue factor (TF)-activated plasma samples. PC was activated by endogenously generated thrombin after addition of soluble thrombomodulin (TM). The capability of activated PC (APC) to suppress thrombin formation was significantly more pronounced in adult than in cord plasma. Addition of 4 nm of TM decreased the thrombin potential (TP) in cord plasma by 10%, and in adult plasma by 52% in the presence of 5 pm TF. We demonstrate that this low anticoagulant action of PC is attributable to the low levels of tissue factor pathway inhibitor (TFPI) and antithrombin (AT) physiologically present in cord plasma. Addition of 4 nm TM decreased the TP by 58% in cord plasma adjusted to contain TFPI and AT at adult levels in the presence of 5 pm TF. Thus, the combined low anticoagulant action of the three inhibitors APC, TFPI, and AT in cord plasma allows enhanced thrombin formation associated with shorter clotting times compared with adult plasma when low amounts of TF are applied to initiate clot formation. Although our laboratory experiments do not allow definite conclusions for various clinical situations, our data might contribute to explain excellent hemostasis in neonates despite low levels of procoagulants.
Find related publications in this database (using NLM MeSH Indexing)
Adult -
Anticoagulants - pharmacology
Blood Coagulation Factors - metabolism
Coagulants - pharmacology
Dose-Response Relationship, Drug - pharmacology
Fetal Blood - metabolism
Humans - metabolism
Infant, Newborn - metabolism
Lipoproteins - blood
Plasma - metabolism
Protein C - metabolism
Protein C Inhibitor - metabolism
Thrombin - metabolism
Thrombomodulin - metabolism
Thromboplastin - metabolism
Time Factors - metabolism
Umbilical Cord - metabolism

Find related publications in this database (Keywords)
thrombomodulin
activated protein C
tissue factor pathway inhibitor
antithrombin
thrombin potential
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