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Elevated plasma CL-K1 level is associated with a risk of developing disseminated intravascular coagulation (DIC)

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Abstract

Collectin kidney 1 (CL-K1) is a recently identified collectin that is synthesized in most organs and circulates in blood. CL-K1 is an innate immune molecule that may play a significant role in host defense. As some collectins also play a role in coagulation, we hypothesized that an effect of CL-K1 may be apparent in disseminated intravascular coagulation (DIC), a gross derangement of the coagulation system that occurs in the setting of profound activation of the innate immune system. DIC is a grave medical condition with a high incidence of multiple organ failure and high mortality and yet there are no reliable biomarkers or risk factors. In our present study, we measured plasma CL-K1 concentration in a total of 659 specimens, including 549 DIC patients, 82 non-DIC patients and 27 healthy volunteers. The median plasma CL-K1 levels in these cohorts were 424, 238 and 245 ng/ml, respectively, with no significant difference in the latter two groups. The incidence of elevated plasma CL-K1 was significantly higher in the DIC patients compared to the non-DIC patients, resulting in an odds ratio of 1.929 (confidence interval 1.041–3.866). Infection, renal diseases, respiratory diseases, and cardiac diseases were more frequently observed in the DIC group than in the non-DIC group. In the DIC group, vascular diseases were associated with elevated plasma CL-K1 levels while age and acute illness had little effect on plasma CL-K1 levels. Independent of DIC, elevated plasma CL-K1 levels were associated with respiratory disease and coagulation disorders. These results suggest that specific diseases may affect CL-K1 synthesis in an organ dependent manner and that elevated plasma CL-K1 levels are associated with the presence of DIC. Further investigations in cohorts of patients are warranted. We propose that elevated plasma CL-K1 may be a new useful risk factor and possibly biomarker for the prediction of developing DIC.

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Acknowledgments

The authors thank laboratory personnel in the Coagulation Laboratory at the Massachusetts General Hospital. The work was supported in part by NIH Grant U01-074503 (K.T.) and Grants-in-Aid for Scientific Research of the Japan of Ministry of Education, Culture, Sports, Science, and Technology, 19390227 (N.W). This work was also supported by grants from Fuso Pharmaceutical Industry, Co., the Smoking Research Foundation, and the Mizutani foundation for glycoscience (N.W).

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Authors and Affiliations

  1. Department of Pediatrics, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA

    Kazue Takahashi, Patience Moyo & Lorencia Chigweshe

  2. Department of Microbiology and Immunochemistry, Asahikawa Medical University, Asahikawa, Hokkaido, 078-8510, Japan

    Katsuki Ohtani & Nobutaka Wakamiya

  3. Divisions of Neuroradiology and Nuclear Medicine and Molecular Imaging, Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, 02114, USA

    Mykol Larvie

  4. Department of Pathology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, 02114, USA

    Elizabeth M. Van Cott

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  1. Kazue Takahashi
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Correspondence to Kazue Takahashi.

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Elizabeth M. Van Cott and Nobutaka Wakamiya are co-senior authors.

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Takahashi, K., Ohtani, K., Larvie, M. et al. Elevated plasma CL-K1 level is associated with a risk of developing disseminated intravascular coagulation (DIC). J Thromb Thrombolysis 38, 331–338 (2014). https://doi.org/10.1007/s11239-013-1042-5

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