Origin of coagulation-activating factors in the acute phase of trauma, their different coagulation activation capacities, and the timing of their release.

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K09036
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 55060:Emergency medicine-related
• Research Institution: Hokkaido University
• Principal Investigator: Hayakawa Mineji 北海道大学, 大学病院, 准教授 (10374282)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: 外傷 / 血液凝固

Outline of Final Research Achievements

In blunt trauma, parenchymal organs, muscles, and bones are damaged by the external force. In this study, using a rat model of blunt trauma, we clearly showed that the micro particles (MPs) and various DAMPs released immediately after injury correlate with the deviating enzymes from skeletal muscle. In addition, when the severity of trauma was quantitatively increased in the model, MPs, DAMPs, and skeletal muscle-depleting enzymes increased in proportion to the severity of trauma, indicating that the activation of coagulation immediately after trauma injury originated from the injured parenchymal organs.
Furthermore, no significant differences in MPs activity were observed between organs. However, with regard to tPA activity, tPA activity in the lungs was significantly higher.

Free Research Field

救急医学

Academic Significance and Societal Importance of the Research Achievements

外傷受傷直後の凝固障害が、損傷した骨格筋を含む実質臓器に由来することが明らかになることにより、外傷による損傷部位の違いにより、傷病者の凝固障害の程度やその進展様式（凝固活性化による２次線溶が主体なのか/損傷臓器由来のtssue-plasminogen activatorによる直接的な線溶亢進が主体なのか）が異なる可能性の推測が可能となった。
このことにより、重症外傷患者の凝固障害に対する治療介入の手掛かりが得られる可能性がある。