Inhibitory effects of amniotic fluid on the activated protein C anticoagulation system in maternal plasma
Inhibitory effects of amniotic fluid on the activated protein C anticoagulation system in maternal plasma
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羊水对母体血浆中活化的C蛋白抗凝系统的抑制作用
DOI：
10.1007/s11239-021-02513-4
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发表时间：
2021
影响因子：
4
通讯作者：
Tamura Naoaki
中科院分区：
文献类型：
--
作者：
Jain Divyanu;Oda Tomoaki;Kawai Kenta;Horikoshi Yoshimasa;Matsumoto Masako;Narumi Megumi;Kohmura-Kobayashi Yukiko;Furuta-Isomura Naomi;Yaguchi Chizuko;Uchida Toshiyuki;Suzuki Kazunao;Kanayama Naohiro;Itoh Hiroaki;Tamura Naoaki
肺血栓栓塞（PTE）是孕产妇死亡的主要原因之一。我们以前曾报道，羊水（AF）进入母体循环的可能污染加速凝血酶的产生，并通过外源性途径激活母体血液中的血小板功能，这可能与产后早期PTE的高发病率有关。然而，目前尚不清楚母体的抗凝系统，例如，活化的蛋白C（APC）通路有助于由AF诱导的高凝状态。我们先前使用基于内源性凝血酶电位（ETP）的测定的研究揭示，在产后第一天，即，我们的目的是探讨母体血浆APC与AF混合时的易感性。我们收集了51名孕妇的血浆，并与AF以及APC混合。使用基于ETP的测定计算APC敏感性比（APC-sr）。在母体血浆中加入AF，在APC存在下ETP显著增加。APC-sr显著增加，表明对APC的敏感性降低后，AF混合物到母体血浆。目前APC-sr与AF污染的差异小于我们以前报告的静脉血栓栓塞病例。AF对APC抗凝通路的抑制作用可能有助于，至少部分地，进一步促进AF诱导的凝血酶产生。结合其他经典的血栓形成危险因素，目前的研究结果支持可能参与AF暴露在产后早期PTE的高发病率。
Pulmonary thromboembolism (PTE) is one of the leading causes of maternal mortality. We previously reported that possible contamination of amniotic fluid (AF) into maternal circulation accelerated thrombin production and activated platelet function in maternal blood through the extrinsic pathway, which may be associated with the high incidence of PTE in early puerperium. However, it remains unclear whether the maternal anticoagulation system, e.g., the activated protein C (APC) pathway, contributes to the hypercoagulable condition induced by AF. Our previous study using an endogenous thrombin potential (ETP)-based assay revealed that sensitivity to APC was reduced during the postpartum first day, i.e., immediately after delivery, when parturients were supposed to be exposed to AF. Our aim is to investigate the susceptibility of maternal plasma to APC when mixed with AF. We collected plasma from 51 pregnant females and mixed with AF as well as APC. APC-sensitivity ratio (APC-sr) was calculated using the ETP-based assay. Addition of AF to maternal plasma showed a significant increase of ETP in the presence of APC. APC-sr was significantly increased, indicating decreased sensitivity to APC, after AF mixture to maternal plasma. The present APC-sr difference with AF contamination was smaller than that we reported previously in venous thromboembolism cases. The inhibitory effects of AF on the APC anticoagulation pathway may contribute, at least partly, to further promotion of thrombin production induced by AF. Combined with other classical thrombophilic risk factors, the present findings support possible involvements of AF exposure in the high incidence of PTE in early puerperium.
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通过内源性凝血酶电位检测检测妊娠期间对活化蛋白 C 的反应降低
影响因子：
5.7
作者：
M. Sugimura;Takao Kobayashi;N. Kanayama;T. Terao
通讯作者：
T. Terao
羊水中的α1-抗胰蛋白酶。
DOI：
10.1016/s0140-6736(73)90385-1
发表时间：
1973
期刊：
The Lancet
影响因子：
--
作者：
E. Wilkinson;T. Hosty;J. Straumfjord
通讯作者：
J. Straumfjord
影响因子：
6.5
作者：
F. Mathonnet;Philippe Demazancourt;B. Bastenaire;M. Morot;N. Benattar;S. Beufé;J. Borg;Y. Giudicelli
通讯作者：
Y. Giudicelli
影响因子：
7.5
作者：
ESPANA, F;GILABERT, J;CABO, A
通讯作者：
CABO, A