Ratio of von Willebrand factor propeptide to ADAMTS13 is associated with severity of sepsis.

Von Willebrand factor (VWF)-cleaving protease (ADAMTS13) cleaves ultralarge VWF (ULVWF) secreted from endothelium and by which is regulating its physiologic function. An imbalance between ULVWF secretion and ADAMTS13 level occurs in sepsis and may cause multiple organ dysfunction. We evaluated the association between the VWF-propeptide (VWF-pp)/ADAMTS13 ratio and disease severity in patients with severe sepsis or septic shock. In 27 patients with severe sepsis or septic shock and platelet count less than 120,000/μL, we measured plasma VWF, VWF-pp, and ADAMTS13 levels on hospital days 1, 3, 5, and 7. The VWF-pp/ADAMTS13 ratio was increased greater than 12-fold in patients with severe sepsis or septic shock on day 1 and remained markedly high on days 3, 5, and 7 compared with normal control subjects. The VWF-pp/ADAMTS13 ratio significantly correlated with Acute Physiology and Chronic Health Evaluation II score on days 1 and 5; Sepsis-related Organ Failure Assessment score on days 1, 3, and 5; maximum Sepsis-related Organ Failure Assessment score and tumor necrosis factor α level on days 1, 3, 5, and 7; and creatinine level on days 1, 5, and 7. Patients with greater than stage 1 acute kidney injury had significantly higher VWF-pp/ADAMTS13 ratio than patients without acute kidney injury. In summary, the VWF-pp/ADAMTS13 ratio was associated with disease severity in patients with severe sepsis or septic shock and may help identify patients at risk for multiple organ dysfunction by detecting severe imbalance between ULVWF secretion and ADAMTS13 level.;博士(医学)・乙第1318号・平成25年7月22日;開始ページ : 409;終了ページ : 414;PubMed番号 : http://www.ncbi.nlm.nih.gov/pubmed/23481506

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書名 Ratio of von Willebrand factor propeptide to ADAMTS13 is associated with severity of sepsis.
著作者等 Asai Hideki
Brazilian Shock Society
European Shock Society
Fujimura Yoshihiro
International Federation of Shock Societies
Matsui Hideto
Matsumoto Masanori
Nishio Kenji
Okuchi Kazuo
Seki Tadahiko
Shock Society
Sugimoto Mitsuhiko
Watanabe Tomoo
Fukushima Hidetada
出版元 Lippincott Williams & Wilkins
ページ数 v.
大きさ 28 cm
ISSN 10732322
NCID AA11017168
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言語 英語
出版国 アメリカ合衆国
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