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Fig. 5 | Critical Care

Fig. 5

From: Endotheliopathy in septic conditions: mechanistic insight into intravascular coagulation

Fig. 5

Suppression of coagulation by recombinant thrombomodulin (rTM) and antithrombin (rAT). a Thrombin generation on the surface of endothelial cells (ECs) pretreated with LPS was monitored for 30 min using a synthetic fluorogenic substrate for thrombin (SN-20) with antithrombin (AT)-deficient plasma and CaCl2. AT-deficient plasma was either unsupplemented or supplemented with rAT to achieve the plasma AT activity of 0, 30, 70, or 100%. Thrombin generation was partially suppressed by the supplementation with rAT. b Thrombin generation on the surface of ECs pretreated with LPS was monitored for 30 min using a synthetic fluorogenic substrate for thrombin (SN-20) with normal human plasma and CaCl2. Plasma samples were supplemented with 100 or 2500 ng/mL of rTM, which corresponded to minimum and maximum plasma concentrations in the clinical setting. Thrombin generation was partially suppressed by the supplementation with rTM. c Thrombin generation on the surface of ECs pretreated with LPS was monitored for 30 min using a synthetic fluorogenic substrate for thrombin (SN-20) with diluted human plasma (67% plasma) and CaCl2. Concomitant use of rTM (2500 ng/mL) and rAT (33%) showed additive effects and efficiently suppressed thrombin generation. Detailed methods and results are provided in Additional files 2 and 3

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