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Evaluation of Plasma Level of Soluble CLEC2, a Novel Platelet Activation Marker, in Patients with Sepsis Induced Coagulopathy -A Pilot Study

H. Ishikura1, Y. Irie1, K. Hoshino1, J. Maruyama1, M. Nakashio1, M. Kawamura2, K. Suzuki-Inoue3

1Fukuoka University / Faculty of Medicine, Emergency and Critical Care Medicine, Fukuoka, Japan, 2LSI Medience, Tokyo, Japan, 3University of Yamanashi / Faculty of Medicine, Clinical and Laboratory Medicine, Chuo, Japan

Abstract Number: PB0447

Meeting: ISTH 2020 Congress

Theme: Diagnostics and OMICs » Biomarkers of Thrombosis and Hemostasis

Background: C-type lectin-like receptor 2 (CLEC2) is a platelet-activated receptor expressed on the surface of platelet membranes and soluble CLEC2 (sCLEC2) is receiving attention as a predictive marker for evaluating thrombotic predisposition such as cerebral or myocardial infarction.

Aims: We examined the relationship between plasma sCLEC2 level and the degree of coagulation disorder, especially platelet activation in patients with sepsis-induced coagulopathy (SIC).

Methods: This is a single-center retrospective observational study from April 2015 to March 2018. 71 sepsis patients were enrolled and divided into sepsis with disseminated intravascular coagulation (DIC) and without DIC at the time of ICU admission, according to Japanese Acute Medical Association (JAAM) DIC criteria (JAAM DIC score ≥4). In addition, 37 healthy adult volunteer were enrolled as a control. We measured plasma sCLEC2 level by ELISA and compared with this level in each group.

Results: Since we suspected sCLEC2 levels were likely to be affected by platelet count, we attempted to calculate the sCLEC2/platelet count ratio (called the C2PAC index). The C2PAC index in healthy volunteer, sepsis without DIC and sepsis with DIC was 0.34 ± 0.15, 1.26 ± 0.69, 2.77 ± 2.44, respectively, and the C2PAC index of sepsis patients was significantly higher than that of healthy volunteers (p< 0.001). Moreover, the C2PAC index of sepsis patients with DIC was significantly higher compared with the sepsis patients without DIC (p< 0.001).
Furthermore, we divided the sepsis induced DIC patients into four groups (JAAM DIC 0-1, 2-3, 4-5 and ≧6) using the JAAM DIC scoring system. The C2PAC index of each group were 1.18±0.62, 1.38±0.86, 2.41±2.47, and 3.91±2.20, and as the DIC score increased, the value of the C2PAC index also increased significantly (p=0.002).

Conclusions: We suggested that the evaluation of C2PAC index might be a predictor of SIC progression in sepsis patients.

To cite this abstract in AMA style:

Ishikura H, Irie Y, Hoshino K, Maruyama J, Nakashio M, Kawamura M, Suzuki-Inoue K. Evaluation of Plasma Level of Soluble CLEC2, a Novel Platelet Activation Marker, in Patients with Sepsis Induced Coagulopathy -A Pilot Study [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/evaluation-of-plasma-level-of-soluble-clec2-a-novel-platelet-activation-marker-in-patients-with-sepsis-induced-coagulopathy-a-pilot-study/. Accessed September 27, 2023.

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