KAWAGUCHI Chiharu Nara Medical University, School of Medicine, Lecturer, 医学部, 講師 (60316073)
NISHIKUBO Toshiya Nara Medical University school of Medicine, School of Medicine, Associate Professor, 医学部, 助教授 (20208169)
YASUHARA Hajime Nara Medical University School of Medicine, School of Medicine, Assistant, 医学部, 助手 (00398447)
ARAI Ikuyo Nara Medical University School of Medicine, School of Medicine, Assistant, 医学部, 助手 (80405406)
|Budget Amount *help
¥3,100,000 (Direct Cost: ¥3,100,000)
Fiscal Year 2006: ¥1,100,000 (Direct Cost: ¥1,100,000)
Fiscal Year 2005: ¥2,000,000 (Direct Cost: ¥2,000,000)
From the nation-wide survey of neonatal thrombosis in Japan supported by this foundation, the frequency of neonatal thrombosis in Japan was one-tenth lower than that of western countries. But, this survey was retrospective, and the diagnostic criteria were not fully assured. Therefore, it is unclear whether the difference is due to the race or the diagnostic skill. However, the etiology and patho-physiology of neonatal thrombosis from this survey were similar to those of the reports from western countries. The therapy of neonatal thrombosis in Japan was mostly conservative, but the fibrinolytic therapy, such as u-PA or t-PA, was used in some cases as in adult cases. But, the doses and the timing of the fibrinolytic therapy were not assured and then it needs to establish it near future. In this survey, the incidence of the genetic factors was very low. But in our experience, the plasma levels of protein C or another anti-thrombotic factor were very low comparing with the matched-aged-co
ntrol values. And these factors gradually reached to the control values with the growth. Therefore, the genetic factor is not to be denied but it seems that the low anti-thrombotic factor is one of the risk factors in neonatal thrombosis.
Until now, the plasma levels of the coagulation and fibrinolytic factors in newborn are intensively investigated, but the recent researches and our studies demonstrate that it is important to evaluate it in the whole blood milieu included the platelets from the physiological perspective. At that time, it was suggested that the platelet-activation factors, such as small amount of thrombin and ADP exaggerated the coagulation, then, it is important to regulate these platelet-activation factors for the understanding the homeostasis and thrombosis in the newborn. From the study on the activated VII (VIIa) developed for the treatment of the bleedings in patients with hemophilia inhibiter, The VIIa pathway is important to physiologic haemostatic mechanism and Vila induced the effective homeostasis even in a few amount of platelets.
It is also necessary to reveal the physiological haemostatic regulatory system. Thrombin activatable inhibitory factor (TAFI) was established by the immunological method, we continued the measurement of plasma levels in newborn at several patho-physiological conditions. We revealed the some physiological significance in the newborn homeostasis and continued the study.
Finally, we will reveal the risk factors of neonatal thrombosis and establish the diagnostic criteria, and perform the prospective study near future. Less