Тромбоз, гемостаз и реология

Tromboz, Gemostaz I Reologiya
scientific and practical journal

ISSN 2078–1008 (Print); ISSN 2687-1483 (online)
2021, Original papers
2021

The role of syndecan‐1 for DIC diagnosis in hemoblastosis patients with sepsis: 616.15-008.1:616.15-07

Original papers
Published 2021-11-30
Alexey Lyanguzov
Kirov Research Institute of Hematology and Blood Transfusion, Federal Medical and Biological Agency of Russia; 72 Krasnoarmeiskaya Str., Kirov 610027, Russia
ФГБУН «Кировский научно-исследовательский институт гематологии и переливания крови Федерального медико-биологического агентства России»; Россия, 610027 Киров, ул. Красноармейская, 72
Olga Sergunina
Kirov Research Institute of Hematology and Blood Transfusion, Federal Medical and Biological Agency of Russia; 72 Krasnoarmeiskaya Str., Kirov 610027, Russia
ФГБУН «Кировский научно-исследовательский институт гематологии и переливания крови Федерального медико-биологического агентства России»; Россия, 610027 Киров, ул. Красноармейская, 72
Sergey Ignatyev
Kirov Research Institute of Hematology and Blood Transfusion, Federal Medical and Biological Agency of Russia; 72 Krasnoarmeiskaya Str., Kirov 610027, Russia
ФГБУН «Кировский научно-исследовательский институт гематологии и переливания крови Федерального медико-биологического агентства России»; Россия, 610027 Киров, ул. Красноармейская, 72
Elena Nazarova
Kirov Research Institute of Hematology and Blood Transfusion, Federal Medical and Biological Agency of Russia; 72 Krasnoarmeiskaya Str., Kirov 610027, Russia
ФГБУН «Кировский научно-исследовательский институт гематологии и переливания крови Федерального медико-биологического агентства»; Россия, 610027 Киров, ул. Красноармейская, 72
Svetlana Kalinina
Kirov Research Institute of Hematology and Blood Transfusion, Federal Medical and Biological Agency of Russia; 72 Krasnoarmeiskaya Str., Kirov 610027, Russia
ФГБУН «Кировский научно-исследовательский институт гематологии и переливания крови Федерального медико-биологического агентства России»; Россия, 610027 Киров, ул. Красноармейская, 72
Natalia Zorina
Kirov Research Institute of Hematology and Blood Transfusion, Federal Medical and Biological Agency of Russia; 72 Krasnoarmeiskaya Str., Kirov 610027, Russia
ФГБУН «Кировский научно-исследовательский институт гематологии и переливания крови Федерального медико-биологического агентства»; Россия, 610027 Киров, ул. Красноармейская, 72
Natalia Minaeva
Kirov Research Institute of Hematology and Blood Transfusion, Federal Medical and Biological Agency of Russia; 72 Krasnoarmeiskaya Str., Kirov 610027, Russia
ФГБУН «Кировский научно-исследовательский институт гематологии и переливания крови Федерального медико-биологического агентства»; Россия, 610027 Киров, ул. Красноармейская, 72
Andrey Bulanov
Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare Department; 3 Bolshaya Sukharevskaya Square, Moscow 129010, Russia
ГБУЗ «Научно-исследовательский институт скорой помощи имени Н.В. Склифосовского Департамента здравоохранения города Москвы»; Россия, 129010 Москва, Большая Сухаревская площадь, 3; ФГБОУ ВО «Московский государственный медико-стоматологический университет имени А.И. Евдокимова»; Россия, 127473 Москва, Делегатская ул., 20/1
Igor Paramonov
Kirov Research Institute of Hematology and Blood Transfusion, Federal Medical and Biological Agency of Russia; 72 Krasnoarmeiskaya Str., Kirov 610027, Russia
ФГБУН «Кировский научно-исследовательский институт гематологии и переливания крови Федерального медико-биологического агентства»; Россия, 610027 Киров, ул. Красноармейская, 72

Keywords

hemablastosis
DIC
sepsis
endothelial glycocalyx damage
syndecan-1
  Full Text

Abstract

Summary. Background. Disseminated intravascular coagulation (DIC) is a severe complication of hemoblastosis. The key role of the vascular endothelium in hemostasis regulation is well known. Its activation and damage are the most important factors of consumption coagulopathy during systemic inflammation. Increased blood level of one of the main proteoglycans of the endothe- lial glycocalyx — syndecan-1 has been described in various pathological conditions, including acute leukemia and DIC. Syndecan-1 level evaluation in patients with hemoblastosis can help early DIC diagnosis and improve therapy results. Objectives: to assess the role of syndecan-1 for DIC diagnosis in hemablastosis patients with sepsis. Patients/Methods. Hematological and biochemical data of peripheral blood, coagulogram, acid-base balance and serum level of syndecan-1 were analyzed in 54 patients with hemo- blastosis with signs of systemic inflammation. Acute myeloid leukemia was diagnosed in 19 (35%) patients, acute lymphoblastic leukemia — in 10 (18%), non-Hodgkin’s lymphoma — in 13 (24%), Hodgkin’s lymphoma — in 9 (17%), multiple myeloma — in 3 (6%). Syndecan-1 concentration was compared with that of healthy donors. DIC was assessed by DIC-score (ISTH, International Society on Thrombosis and Hemostasis), organ dysfunction — by SOFA (Sequential Organ Failure Assessment) score. Sepsis was verified according to the third international consensus definitions for sepsis and septic shock. Relationship of syndecan-1 level with hema- tological, сoagulological, biochemical data and DIC or SOFA scores was assessed by Spearman rank correlation. The diagnostic value of syndecan-1 was determined by ROC-analysis. Results. Increased level of syndecan-1 in 5.8 times was revealed in patients with hemoblastosis in comparison to healthy donors (p = 0.008). Sepsis was diagnosed in 28 (52%) patients, overt DIC — in 14 (25%). Serum syndecan-1 level correlated with activated partial thromboplastin time, prothrombin time, platelet count, antithrombin III activity, DIC and SOFA scores. The diagnostic role of syndecan-1 was determined in overt DIC (cut-off — 5.48 ng/ml, sensitivity — 73%, specificity — 90%). Conclusions. Increased syndecan-1 level (more than 5.48 ng/ml) can be additional diagnostic criterion for DIC in patients with hematological malignancies and sepsis.

References:

  1. Kurita N., Sakamoto T., Kato T. et al. The prognosis of disseminated intravascular coagulation associated with hematologic malig- nancy and its response to recombinant human thrombomodulin. Thromb Res. 2019;173:57–64. DOI: 10.1016/j.thromres.2018.11.014. 

  2. Chi S., Ikezoe T. Disseminated intravascular coagulation in non- Hodgkin lymphoma. Int J Hematol. 2015;102(4):413–9. DOI: 10.1007/ s12185–015–1854–5. 

  3. Yanada M., Matsushita T., Suzuki M. et al. Disseminated intra- vascular coagulation in acute leukemia: clinical and laboratory features at presentation. Eur J Haematol. 2006;77(4):282–7. DOI: 10.1111/j.1600–0609.2006.00711.x. 

  4. Chang H., Kuo M.C., Shih L.Y. et al. Clinical bleeding events and laboratory coagulation profiles in acute promyelocytic leu- kemia. Eur J Haematol. 2012;88(4):321–8. DOI: 10.1111/j.1600– 0609.2011.01747.x. 

  5. Vitale F.V., Longo-Sorbello G.S., Rotondo S., Ferrau F. Understan- ding and treating solid tumor-related disseminated intravascular coagulation in the «era» of targeted cancer therapies. SAGE Open Med. 2017;5:2050312117749133. DOI: 10.1177/2050312117749133. 

  6. Ignatyev S. V., Zotina E. N., Fokina Е. S. et al. Procoagulantive state in patients with non-Hodgkin’s lymphomas. Tromboz, gemostaz i reologiya. 2018;(3):35–40. (In Russ.). DOI: 10.25555/ THR.2018.3.0849. 

  7. Ignat’ev S.V., Lyanguzov A.V. The functional role of microvesi- cles in norm and pathology. Klinicheskaya fiziologiya krovoobrash- cheniya. 2019;16(4):261–6. (In Russ.). DOI: 10.24022/1814–6910– 2019–16–4–261–266. 

  8. Lyanguzov A.V., Kolotilov L.V., Zagoskina T.P. Rhabdomyoly- sis in patients with hemoblastosis during intensive chemothe- Obshchaya reanimatologiya. 2009;5(4):60–5. (In Russ.). DOI: 10.15360/1813–9779–2009–4–60. 

  9. Iba T., Levi M., Levy J.H. Sepsis-induced coagulopathy and dis- seminated intravascular coagulation. Semin Thromb Hemost. 2020;46(1):89–95. DOI: 10.1055/s-0039–1694995. 

  10. Ilyina Ya. Yu., Fot EV, Kuzkov VV, Kirov M. Yu. Sepsis-induced damage to the endothelial glycocalyx (literature review). Vestnik intensivnoj terapii imeni A.I. Saltanova. 2019;(2):32–9. (In Russ.). DOI: 10.21320/1818–474X-2019–2–32–39.
  11. Chappell D., Westphal M., Jacob M. The impact of the glycoc- alyx on microcirculatory oxygen distribution in critical ill- ness. Curr Opin Anaesthesiol. 2009;22(2):155–62. DOI: 10.1097/ ACO.0b013e328328d1b6.
  12. Iba T., Levy J.H., Raj A., Warkentin T.E. Advance in the manage- ment of sepsis-induced coagulopathy and disseminated intra- vascular coagulation. J Clin Med. 2019;8(5):728. DOI: 10.3390/ jcm8050728.
  13. Alghandour R., Ebrahim M.A., Ghazy H. et al. Evaluation of the diagnostic and prognostic value of syndecan-1 in acute leukemia patients. Cureus. 2020;12(9):e10594. DOI: 10.7759/cureus.10594.
  14. Huang X., Hu H., Sun T. et al. Plasma endothelial glycocalyx com- ponents as a potential biomarker for predicting the development of disseminated intravascular coagulation in patients with sep- sis. J Intensive Care Med. 2020 Aug 17:885066620949131. DOI: 10.1177/0885066620949131. [Online ahead of print].
  15. Rhodes A., Evans L.E., Alhazzani W. et al. Surviving sepsis cam- paign: international guidelines for management of sepsis and septic shock. 2016. Intensive Care Med. 2017;43(3):304–77. DOI: 10.1007/s00134–017–4683–6.
  16. Levi M., van der Poll T. Coagulation and sepsis. Thromb Res. 2017;149:38–44. DOI: 10.1016/j.thromres.2016.11.007.
  17. Vasileiadis I., Politou M., Dimopoulos S. et al. Variation of endothelium-related hemostatic factors during sepsis. Microcir- culation. 2018;25(8): e12500. DOI: 10.1111/micc.12500.
  18. Vink H., Constantinescu A.A., Spaan J.A. Oxidized lipoproteins degrade the endothelial surface layer: implications for platelet- endothelial cell adhesion. Circulation. 2000;101(13):1500–2. DOI: 10.1161/01.cir.101.13.1500.
  19. Nagy N., Freudenberger T., Melchior-Becker A. et al. Inhibi- tion of hyaluronan synthesis accelerates murine atherosclerosis: novel insights into the role of hyaluronan synthesis. Circulation. 2010;122(22):2313–22. DOI:10.1161/CIRCULATIONAHA.110.972653.
  20. Semeraro N., Ammollo C.T., Semeraro F., Colucci M. Coagulopa- thy of acute sepsis. Semin Thromb Hemost. 2015;41(6):650–8. DOI: 10.1055/s-0035–1556730.
  21. Iba T., Ito T., Maruyama I. et al. Potential diagnostic markers for disseminated intravascular coagulation of sepsis. Blood Rev. 2016;30(2):149–55. DOI: 10.1016/j.blre.2015.10.002.
  22. Sinkov S. V., Roitman E. V., Zabolotskikh I. B. New criteria for sepsis-induced coagulopathy. Review. Vestnik intensivnoj terapii imeni A.I. Saltanova. 2019;(3):52–7. (In Russ.). DOI: 10.21320/1818– 474X-2019–3–52–57.
  23. Taylor F.B., Toh C.H., Hoots W.K. et al.; Scientific Subcommittee on Disseminated Intravascular Coagulation (DIC) of the Interna- tional Society on Thrombosis and Haemostasis (ISTH). Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation. Thromb Haemost. 2001;86(5):1327–30. PMID: 11816725.
  24. Spero J.A., Lewis J.H., Hasiba U. Disseminated intravascular coagu- Findings in 346 patients. Thromb Haemost. 1980;43(1):28– 33. PMID: 6773170.
  25. Li W.J., Sha M., Ma W. et al. Efficacy evaluation of D-dimer and modified criteria in overt and nonovert disseminated intravas- cular coagulation diagnosis. Int J Lab Hematol. 2016;38(2):151–9. DOI: 10.1111/ijlh.12467.
  26. Lyanguzov A.V., Kalinina S.L., Ignatyev S.V. et al. Viscoelastic pro- perties of a blood clot and the manifestations of hemorrhagic syn- drome in thrombocytopeniс patients with hemoblastosis. Trom- boz, gemostaz i reologiya. 2020;(4):102–8. (In Russ.). DOI: 10.25555/ THR.2020.4.0952.