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From the National Cardiovascular Center, Research Institute (T.K., K-i.E., M.H.-S., A.Y., H. Kato) and Hospital (Division of Atherosclerosis and Metabolism; H. Koh, M.T.), Osaka, and Chemo-Sera-Therapeutics Research Institute, Kumamoto (K.K., Y-i.K.), Japan.
Correspondence to Dr H. Kato, National Cardiovascular Center Research Institute, Fujishirodai-5, Suita, Osaka 565, Japan.
Abstract Tissue factor pathway inhibitor (TFPI), a protease with three tandem Kunitz-type (K1, K2, and K3) domains, inhibits the initial reaction of the TF-mediated coagulation pathway. TFPI occurs in a free and a lipoprotein-associated form in plasma as well as an endothelial cellassociated form on vascular walls. In a previous study we had demonstrated that free-form TFPI activity was lower in hyperlipidemic patients. In the present study we established a new enzyme immunoassay method for measuring free-form TFPI antigen; this new method uses a monoclonal antibody that recognizes the K3 domain of free-form TFPI but not lipoprotein-associated TFPI. Free-form TFPI antigen was significantly lower in hyperlipidemic patients compared with those in normolipidemic individuals. We applied this new method to measure the amount of endothelial cellassociated TFPI, which can be released by heparin injection, as "free-form TFPI." We found that free-form TFPI antigen in plasma was positively correlated with the endothelial cellassociated form. These results indicate that both of these forms of TFPI are in equilibrium in vivo and that our new method can be used for assessing changes in the levels of endothelial cellassociated TFPI antigen and, hence, for assessing thrombotic tendencies in various disease states.
Key Words: enzyme immunoassay hyperlipidemia endothelial cell plasmapheresis tissue factor pathway inhibitor
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