Ji-Eun Kim1, Nuri Lee2, Ja-Yoon Gu3, Hyun Ju Yoo4, Hyun Kyung Kim5. 1. Department of Laboratory Medicine and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Cancer Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 110-799, Korea. Electronic address: youe99@naver.com. 2. Department of Laboratory Medicine and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Cancer Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 110-799, Korea. Electronic address: leonuri@naver.com. 3. Department of Laboratory Medicine and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Cancer Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 110-799, Korea. Electronic address: jayoon20@gamil.com. 4. Department of Laboratory Medicine and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Cancer Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 110-799, Korea. Electronic address: ju4101@naver.com. 5. Department of Laboratory Medicine and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Cancer Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 110-799, Korea. Electronic address: lukekhk@snu.ac.kr.
Abstract
INTRODUCTION: Neutrophils can be induced to release DNA combined with histones. The resulting neutrophil extracellular trap (NET) provides a scaffold for growing hemostatic plug. Therefore, the NET formation may be inevitable in clinical conditions that are characterized by formation of vascular thrombi. Thus far, there have been no reports on the clinical significance of NET in disseminated intravascular coagulation (DIC). Therefore, we investigated circulating levels of NET in DIC and analyzed their potential values to assess coagulation severity and predict clinical outcome. METHODS: The plasma levels of DNA-histone complexes and double-stranded DNA (dsDNA), considered to be in vivo markers of NET, were measured in 199 patients suspected of having DIC and 20 healthy controls. RESULT: The circulating levels of DNA-histone complexes and dsDNA were significantly elevated in overt-DIC. The increased levels of these two markers correlated with the severity of coagulopathy including DIC score and D-dimer. Multivariable Cox regression analysis, adjusted for the conventional DIC markers, revealed that elevated DNA-histone complexes and dsDNA are poor independent prognostic markers. CONCLUSION: The circulating levels of NET release reflect the coagulation activation and adverse clinical outcomes in patients with DIC, thereby providing potential clinical relevance for mortality prediction in DIC.
INTRODUCTION: Neutrophils can be induced to release DNA combined with histones. The resulting neutrophil extracellular trap (NET) provides a scaffold for growing hemostatic plug. Therefore, the NET formation may be inevitable in clinical conditions that are characterized by formation of vascular thrombi. Thus far, there have been no reports on the clinical significance of NET in disseminated intravascular coagulation (DIC). Therefore, we investigated circulating levels of NET in DIC and analyzed their potential values to assess coagulation severity and predict clinical outcome. METHODS: The plasma levels of DNA-histone complexes and double-stranded DNA (dsDNA), considered to be in vivo markers of NET, were measured in 199 patients suspected of having DIC and 20 healthy controls. RESULT: The circulating levels of DNA-histone complexes and dsDNA were significantly elevated in overt-DIC. The increased levels of these two markers correlated with the severity of coagulopathy including DIC score and D-dimer. Multivariable Cox regression analysis, adjusted for the conventional DIC markers, revealed that elevated DNA-histone complexes and dsDNA are poor independent prognostic markers. CONCLUSION: The circulating levels of NET release reflect the coagulation activation and adverse clinical outcomes in patients with DIC, thereby providing potential clinical relevance for mortality prediction in DIC.
Authors: Tao Li; Whayoung Lee; Hidetaka Hara; Cassandra Long; Mohamed Ezzelarab; David Ayares; Hai Huang; Yi Wang; Charles T Esmon; David K C Cooper; Hayato Iwase Journal: Transplantation Date: 2017-10 Impact factor: 4.939
Authors: Simon T Abrams; Ben Morton; Yasir Alhamdi; Mohmad Alsabani; Steven Lane; Ingeborg D Welters; Guozheng Wang; Cheng-Hock Toh Journal: Am J Respir Crit Care Med Date: 2019-10-01 Impact factor: 21.405