출혈성 질환에서 Tissue Factor Pathway Inhibitor의 농도 분포 및 Thrombin 형성 능력 조사

Abstract

Background: Tissue factor pathway inhibitor (TFPI) regulates blood coagulation. To treat hemorrhagic disease, studies have been conducted to achieve a hemostatic effect by inhibiting TFPI. In this study, blood TFPI levels of healthy and hemorrhagic disease groups were compared, and the effects of blood TFPI level and its activity on coagulation were investigated. Methods: The blood TFPI levels of the healthy, chronic liver disease (CLD), chronic kidney disease (CKD), and hemophilia groups were measured and compared. Thrombin generation assay (TGA) was performed to investigate the effects of TFPI level and its activity on coagulation. Results: The mean blood TFPI levels of the healthy, CLD, CKD, and hemophilia groups were 16.47 ng/mL, 24.90 ng/mL, 49.47 ng/mL, and 17.35 ng/mL, respectively. The healthy and CLD groups showed correlations between their blood TFPI levels and TGA parameters (P<0.05). The TGA parameters of the CLD and hemophilia groups showed significant differences compared with those of the healthy group (P<0.05). In FVIII-deficient plasma with anti-TFPI antibodies, the TGA parameters tended to be normalized according to anti-TFPI antibody levels. However, the differences in TGA parameters caused by FVIII concentration were unclear. Conclusions: Although the TFPI level was related to bleeding in the disease groups, it is difficult to interpret its effects independently because of the various factors that affect the coagulation process. However, TFPI is worth studying to facilitate the development of a treatment strategy for bleeding due to lack of FVIII.