Introduction: Cerebral venous and sinus thrombosis (CVST) is a potentially serious disorder. In search for underlying coagulopathy in CVST patients, we measured plasma levels of soluble thrombomodulin (sTM) and soluble endothelial protein C receptor (sEPCR) in patients with CVST as candidate biomarkers of thrombosis. Materials and Methods: The concentrations of sTM and sEPCR in 19 CVST patients without protein C and protein S deficiency were measured by ELISA and compared with 53 healthy controls. We also examined the association between those plasma markers and the risk of CVST. Results: Significant difference was identified in plasma sTM level between CVST patients and controls (0.95 ± 0.09 vs. 1.26 ± 0.12 ng/ml, respectively; p = 0.038). The plasma level of sEPCR was not different between groups, and no significant quantitative association was identified between the risk of CVST and the levels of sEPCR. The adjusted odds ratio for CVST associated with low (<10th percentile) levels of sTM was 2.3 (95% CI: 1.29-20.08; p = 0.012) after adjustment for confounding factors. Conclusion: Decreased plasma sTM concentration may be associated with an increased risk of CVST.

1.
Bousser MG, Ferro JM: Cerebral venous thrombosis: an update. Lancet Neurol 2007;6:162-170.
2.
Ferro JM, Canhao P, Stam J, Bousser MG, Barinagarrementeria F: Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVST). Stroke 2004;35:664-670.
3.
Esmon CT: The protein C pathway. Chest 2003;124:26S-32S.
4.
Gandrille S: Endothelial cell protein C receptor and the risk of venous thrombosis. Haematologica 2008;93:812-816.
5.
Ohlin AK, Larsson K, Hansson M: Soluble thrombomodulin activity and soluble thrombomodulin antigen in plasma. J Thromb Haemost 2005;3:976-982.
6.
Cella G, Randi ML, Mennen LI, Amiral J, Guize L, Pujol Y, et al: Soluble thrombomodulin as predictor of incident coronary heart disease. Lancet 1999;354:425.
7.
Goldstein MR: Soluble thrombomodulin as predictor of incident coronary heart disease. Lancet 1999;354:1646-1647.
8.
Esmon CT: The endothelial protein C receptor. Curr Opin Hematol 2006;13:382-385.
9.
Wasay M, Azeemuddin M: Neuroimaging of cerebral venous thrombosis. J Neuroimaging 2005;15:118-128.
10.
Yin YD, Wang C, Zhai ZG, Pang BS, Yang YH, Huang XX: Decreased plasma soluble thrombomodulin levels as a risk factor for pulmonary thromboembolism. J Thromb Thrombolysis 2009;27:274-279.
11.
Nomura E, Kohriyama T, Kozuka K, Kajikawa H, Nakamura S, Matsumoto M: Significance of serum soluble thrombomodulin level in acute cerebral infarction. Eur J Neurol 2004;11:329-334.
12.
Wu KK, Aleksic N, Ballantyne CM, Ahn C, Juneja H, Boerwinkle E: Interaction between soluble thrombomodulin and intercellular adhesion molecule-1 in predicting risk of coronary heart disease. Circulation 2003;107:1729-1732.
13.
Wu KK: Soluble thrombomodulin and coronary heart disease. Curr Opin Lipidol 2003;14:373-375.
14.
Suehisa E, Kawasaki T, Toku M, Hidaka Y: Impaired binding of thrombin to thrombomodulin is associated with risk of deep vein thrombosis. Thromb Res 2008;123:85-92.
15.
Yamagishi K, Cushman M, Heckbert SR, Tsai MY, Folsom AR: Lack of association of soluble endothelial protein C receptor and PROCR 6936A/G polymorphism with the risk of venous thromboembolism in a prospective study. Br J Haematol 2009;145:221-226.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.