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Plasma antigen levels of the lipoprotein-associated coagulation inhibitor
in patient samples
WF Novotny, SG Brown, JP Miletich, DJ Rader and GJ Broze
Division of Hematology/Oncology, Washington University School of Medicine,
Jewish Hospital of St Louis, MO.
Human plasma contains an inhibitor of tissue factor-initiated coagulation
known as the lipoprotein-associated coagulation inhibitor (LACI) or also
known as the extrinsic pathway inhibitor (EPI). A competitive fluorescent
immunoassay was developed to measure the plasma concentration of LACI in
samples from normal individuals and patients with a variety of diseases.
The LACI concentration in an adult control population varied from 60% to
160% of the mean with a mean value corresponding to 89 ng/mL or 2.25
nmol/L. Plasma LACI levels were not decreased in patients with severe
chronic hepatic failure, warfarin therapy, primary pulmonary hypertension,
thrombosis, or the lupus anticoagulant. Plasma LACI antigen was decreased
in some, but not all patients with gram-negative bacteremia and evidence
for disseminated intravascular coagulation. Plasma LACI levels were
elevated in women undergoing the early stages of labor (29%), in patients
receiving intravenous tissue-type plasminogen activator (45%), and in
patients receiving intravenous heparin (375%). A radioligand blot of the
pre- and post-heparin plasma samples shows the increase to be in a 40-Kd
form of LACI. Very low levels of plasma LACI antigen were found in patients
with homozygous abetalipoproteinemia and hypobetalipoproteinemia, diseases
associated with low plasma levels of apolipoprotein B containing
lipoproteins. Following the injection of heparin into one patient with
homozygous abetalipoproteinemia, the plasma LACI antigen level increased to
a level comparable with that in normal individuals after heparin treatment.
Volume 78,
Issue 2,
pp. 387-393,
07/15/1991
Copyright © 1991 by The American Society of Hematology
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