Relationship between protein C antigen and anticoagulant activity during oral anticoagulation and in selected disease states.
Relationship between protein C antigen and anticoagulant activity during oral anticoagulation and in selected disease states.
复制标题
口服抗凝期间和选定疾病状态下蛋白 C 抗原与抗凝活性之间的关系。
DOI：
10.1172/jci112319
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发表时间：
1986
期刊：
影响因子：
--
通讯作者：
D'Angelo,A
中科院分区：
文献类型：
--
作者：
ViganoD'Angelo,S;Comp,PC;Esmon,CT;D'Angelo,A
蛋白C是一种天然的维生素K依赖性血浆抗凝剂，在患有复发性血栓形成和华法林诱导的皮肤坏死的患者中发现了蛋白C的缺乏。为了更充分地了解蛋白C在疾病状态和口服抗凝期间的作用，开发了一种新的蛋白C功能测定法，该测定法涉及血浆蛋白C在Ca+2依赖性单克隆抗体上的吸附、洗脱、定量活化和血浆抗凝活性的评估。当开始口服抗凝时，蛋白C的抗凝活性降低的程度大于酰胺分解或免疫水平。在稳定的华法林治疗期间，酰胺分解或抗原水平与功能性蛋白C活性之间没有相关性，这表明可能需要测量蛋白C抗凝活性以充分反映该蛋白质提供的抗凝保护。相反，在肝衰竭和弥散性血管内凝血中，抗凝剂和酰胺溶解和免疫水平之间存在很强的相关性。两名血栓栓塞性疾病患者的抗凝活性明显降低，但免疫学和酰胺溶解水平正常。因此，该测定允许在接受抗凝治疗的个体中评估蛋白C，并鉴定一类新的蛋白C缺乏个体。
Protein C is a natural vitamin K-dependent plasma anticoagulant, deficiencies of which have been found in patients with recurrent thrombosis and warfarin-induced skin necrosis. To appreciate more fully the role of protein C in disease states and during oral anticoagulation, a new functional assay for protein C involving adsorption of plasma protein C on a Ca+2-dependent monoclonal antibody, elution, quantitative activation, and assessment of plasma anticoagulant activity, has been developed. When oral anticoagulation is initiated, the anticoagulant activity of protein C decreases to a greater extent than either the amidolytic or immunologic levels. During stabilized warfarin treatment, there is no correlation between either amidolytic or antigenic levels and the functional protein C activity, suggesting that measurement of protein C anticoagulant activity may be necessary to reflect adequately the anticoagulant protection afforded by this protein. In contrast, there was a strong correlation between anticoagulant and amidolytic and immunologic levels in liver failure and disseminated intravascular coagulation. Two patients with thromboembolic disease have been identified who exhibit a marked decrease in anticoagulant activity, but who have normal immunologic and amidolytic levels. Thus, this assay permits assessment of protein C in individuals who have received anticoagulant treatment and identification of a new class of protein C-deficient individuals.