Significance of Tissue Factor-Bearing Microparticle Procoagulation Activity and Antithrombin Ⅲ Detection in Thalassemia Patients / 中国实验血液学杂志

OBJECTIVE@#To explore whether the high risk factors possibly leading to hypercoagulative status and thrombosis exist in Thalassemia patients of Guangxi region through detecting plasma tissne factor-bearing microparticles (TFMP), procoagulatima activity, coagulation and anticoagulation function, fibrinolytic function, endothelial function and platelet count.@*METHODS@#The TFMP procoagulation activity was detected by chromogenic saubstract method, the levels of tissue factors (TF), tissue factor pathway inhibitor(TFPI), protein C (PC), protein S (PS), antithrombin Ⅲ(AT-Ⅲ), tissue plasminogen activator (tPA), thrombin-activated fibrinolysis inhibitor (TAFI), soluble E-selectin (sE-sel), intercellular adhesion molecule-1 (ICAM-1) and thrombomodulin (TM) were detected by ELISA in thalassemia group (n=71) and control group (n=20 heathy persons).@*RESULTS@#Compared with control group, the AT-Ⅲ level decreased in β-thalastemia major group (TM) (P<0.05), the AT-Ⅲ level in TM group independeutly posstiody correlated with plt count (r=0.37, P<0.05); the levels of TF and sICAM in α-thalassenia intermediate group (TA) significantly decteased (P<0.05), the procoagulatim activity of TFMP in β-thalassemia intermediate group (TI) increased sngnificantly (P<0.05)， moreover positively corretated with AT-Ⅲ level (r=0.77, P<0.05). The TF and sICAM-1 levels in normal liver functim group of Thalassemia patients were lower tham those in control group (P<0.01 and P<0.05, respectively), the TFMP activity between normal and abnormal liver function was significantly different (P<0.05), while there were no significant difference in other correspoding indexes beween thalassemia group and control group as well as between each thalassemia groups.@*CONCLUSION@#The damage of liver function and reduction of anticoagylation substances exist in patients with β-thalassenia major in Guangxi region, the procoagulation activity of plasma TFMP in patients with β-thalassemia intermedia abnormally increases. All the above-mentioned factors may increase the risk of high coagulation status or thrombosis is thalassemia patients, the decrease of TF and SICAM-1 levels in patients with α-thalassemia intermedia may be factor against thrombosis.

Clinical Significance of Detecting Tissue Factor and Tissue Factor Pathway Inhibitor in Thalassemia Patients / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the changes of E-selectin, thrombin-antithrombin complex（TAT）, prothrombin fragment 1+2（F1+2）, tissue factor（TF）and tissue factor pathway inhibitor（TFPI）before and one year after splenectomy in thalassemia patients.</p><p><b>METHODS</b>A total of 30 thalassemia patients undergoing electric laparoscopic splenectomy and 30 normal controls（NC） were enrolled in the study．Plasma levels of E-selectin, TAT, F1+2, TF and TFPI were detected by enzyme-linked immuno sorbent assay（ELISA）.</p><p><b>RESULTS</b>One year after splenectomy，the plasma concentrations of E-selectin, TAT, F1+2, TF, TFPI were significantly higher than those in both preoperative and NC groups．Levels of E-selectin, TAT, F1+2 before splenectomy were significantly higher than those in NC groups. In addition, there was a positive correlation between plasma TF and TFPI level before and after splenectomy, and the levels of TF and TFPI positively correlated with TAT and F1+2, respectively.</p><p><b>CONCLUSION</b>After splenectomy, the platelet count increases, the activity of endothelial cells is injured, the procoagulant factor increases, the blood is in procoagulant state, the TF/TFPI shows an importent role in the thrombosis of thalassemia patieints after splenectomy and may be used to evaluate the prothrombotic state of this diasease.</p>

Research Advance of Microparticles in Hypercoagulation of Hemolytic Anemia-Review / 中国实验血液学杂志

Microparticles (MP) are small membrane vesicles released from many different cell types in response to cellular activation or apoptosis, which have the procoagulant effect. Hemolytic anemia(HA) is a type of anemia that have a short life expectancy of red blood cells due to the destruction which exceed the hematopoietic compensatory capacity of bone marrow. Sickle cell anemia(SCD), thalassemia and paroxysmal nocturnal hemoglobinuria(PNH) are all characterized by hypercoagulation and thromboembolism (TE). Research shows that MP can promote the formation of hypercoagulative state which in turn increases the risk of thromboembolism in HA. This review mainly summarized the advance research of MP in HA in the past 5 years. Moreover the relationship between the abnormal MP and hypercoagulation in HA, the impact of the related treatment to the MP, the research of MP in animal model of HA and the application of the MP-proteomics in HA are also disscussed.