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Neutrophil extracellular traps (NETs) was considered to play a key role in disseminated intravascular coagulation (DIC). The chromatin filaments were related by activated polymaophonuclear neutrophil and decorated with granule circulating levels of NETs in DIC caused by fulminant myocarditis to analyze coagulation complication severity and predict the outcome.
Surrounding blood collection from 38 fulminant myocarditis patients and 16 healthy subjects were performed to measure the mRNA and protein expression of functional factor at different points, respectively. The serum concentration of cytokine IL-8, IL-6, and TNF-α were detected by ELISA. Meanwhile, plasma levels of DNA-histone complexes and double-stranded DNA(dsDNA), considered to be markers of NETs formation were measured. The NETs were observed by laser confocal microscope directly in two groups.
The mRNA and protein expression levels of active TF which was exposed by NETs were escalated in myocarditis group and serum level of IL-8, IL-6 and TNF-α were elevated. The circulating levels of DNA-histone complexes and double-stranded DNA were significantly elevated and more NETs were observed in fulminant myocarditis patient. The increased marker levels of NETs correlated with coagulopathy severity including DIC score and D-dimer.
The circulating levels of NETs formation reflect the DIC complication and adverse clinical outcomes in patients with fluminant myocarditis.