Marked elevation of the thrombin generation potential following pulsed steroid therapy in a rabbit experiment

DOI 18 References
  • ASHIKAGA Tomoko
    Department of Pediatrics, St. Marianna University School of Medicine
  • YAMASHITA Atsuki
    Department of Pediatrics, St. Marianna University School of Medicine, Yokohama city Seibu Hospital
  • MUTO Shinji
    Department of Pediatrics, St. Marianna University School of Medicine
  • NAGAE Chiai
    Department of Pediatrics, St. Marianna University School of Medicine
  • AKITA Mieko
    Department of Pediatrics, St. Marianna University School of Medicine
  • Suzuki Noriko
    Department of Clinical Laboratory, St. Marianna University School of Medicine Hospital
  • Yamazaki Satoshi
    Department of Clinical Laboratory, St. Marianna University School of Medicine Hospital
  • Takayama Shigenobu
    Faculty of Health Science, Daito Bunka University
  • Tatsunami Shinobu
    Department of medical statistics, St. Marianna University School of Medicine
  • Taki Masashi
    Department of Pediatrics, St. Marianna University School of Medicine, Yokohama city Seibu Hospital

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  • ステロイドパルス治療家兎モデル実験における顕著なトロンビン生成能の上昇

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Abstract

Heparin is often administered along with pulsed steroid therapy, for preventing thrombosis. However, the effects of steroids on blood coagulability remain to be clarified. To clarify the thrombogenicity of steroids, we measured the thrombogenicity using the thrombin generation test (TGT) before and after administration of pulsed methylprednisolone (m-PSL) injections to rabbits. Among the TGT parameters, the lag time was shortened (0.8±0.11 times) and the ETP (1.39±0.31 times) and peak (1.91±0.69 times) were increased in the pulsed m-PSL group as compared to the control group, indicating a marked increase of the thrombin generation potential (TGP) . Plasma factor VII activity (FVII : C) was increased (1.68±0.47 times) in the pulsed m-PSL group. The increased TGP could be reproduced in vitro by the addition of recombinant activated FVII, but not by that of m-PSL. The increased TGP clearly reflected blood hypercoagulability, caused mainly by the elevated FVII : C induced by the drug. However, neither the soluble fibrin (SF) nor D-dimer levels were increased, indicating the thrombosis was not induced by the steroid therapy alone. Therefore, we propose that heparin use during steroid pulse therapy may be clinically appropriate when thrombotic risk factors are associated with the underlying disease.

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