Therapeutic Role of Recombinant Human Soluble Thrombomodulin for Acute Exacerbation of Idiopathic Pulmonary Fibrosis.
Takuma IsshikiSusumu SakamotoSakae HommaPublished in: Medicina (Kaunas, Lithuania) (2019)
Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is an acute respiratory worsening of unidentifiable cause that sometimes develops during the clinical course of IPF. Although the incidence of AE-IPF is not high, prognosis is poor. The pathogenesis of AE-IPF is not well understood; however, evidence suggests that coagulation abnormalities and inflammation are involved. Thrombomodulin is a transmembranous glycoprotein found on the cell surface of vascular endothelial cells. Thrombomodulin combines with thrombin, regulates coagulation/fibrinolysis balance, and has a pivotal role in suppressing excess inflammation through its inhibition of high-mobility group box 1 protein and the complement system. Thus, thrombomodulin might be effective in the treatment of AE-IPF, and we and other groups found that recombinant human soluble thrombomodulin improved survival in patients with AE-IPF. This review summarizes the existing evidence and considers the therapeutic role of thrombomodulin in AE-IPF.
Keyphrases
- idiopathic pulmonary fibrosis
- recombinant human
- respiratory failure
- liver failure
- interstitial lung disease
- endothelial cells
- chronic obstructive pulmonary disease
- oxidative stress
- cell surface
- drug induced
- aortic dissection
- signaling pathway
- rheumatoid arthritis
- transcription factor
- risk factors
- mechanical ventilation
- systemic sclerosis
- high glucose
- free survival