Effect of acute exacerbations on circulating endothelial, clotting and fibrinolytic markers in COPD patients.
Intern Emerg Med
; 8(7): 567-74, 2013 Oct.
Article
en En
| MEDLINE
| ID: mdl-21660493
ABSTRACT
Patients with chronic obstructive pulmonary disease (COPD) are prone to clinical exacerbations that are associated with increased airway inflammation, a potent pro-thrombotic stimulus. Limited information is available on the mechanisms underlying the putative alterations of the endothelial-coagulative system during acute exacerbations. The aim was to investigate whether the activation of the endothelial-coagulative system occurs in association with the acute inflammatory response of COPD exacerbation. We monitored the blood levels of surrogate markers of inflammation interleukin-6 (IL-6); endothelium damage von Willebrand's factor (vWF); clotting activation D-dimer (D-D), and prothrombin fragment 1+2 (F1+2); fibrinolytic response plasminogen activator inhibitor 1 (PAI-1), in COPD subjects, during hospital admission and after clinical resolution. In 30 COPD subjects, IL-6, vWF, D-D and F1+2 levels were elevated during exacerbation and decreased significantly at clinical stability (IL-6, p = 0.005; vWF, p < 0.001; D-D, p < 0.001; F1+2, p < 0.001). PAI-1 levels did not change at exacerbation compared to clinically stable situations. Positive correlations were observed between several of the markers measured. Elevation of IL-6, vWF, D-D and F1+2 levels during COPD exacerbations implies a strict association between acute inflammation, endothelial activation and clotting initiation. This was not associated with a change in PAI-1, implying an increase in the fibrinolytic response to inflammation. The pro-thrombotic nature of COPD exacerbations sustained by enhanced clotting activation appears to be mitigated by excessive fibrinolysis.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Coagulación Sanguínea
/
Endotelio Vascular
/
Biomarcadores
/
Enfermedad Pulmonar Obstructiva Crónica
Límite:
Aged
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Intern Emerg Med
Asunto de la revista:
MEDICINA DE EMERGENCIA
/
MEDICINA INTERNA
Año:
2013
Tipo del documento:
Article