The Thrombomodulin Gene G127A Mutation And Serum Soluble Thrombomodulin Levels In Acute Cerebral Infarction Patients

[Objective]In recent years, the incidence of cerebrovascular disease (CVD) become higher and higher, and give rise serious physical, psychological and economic burden to patients.Studies have shown that hypertension, diabetes, lipid metabolism and smoking and other risk factors can lead to atherosclerosis (AS), cerebral vascular stenosis and occlusion, which result in tissue necrosis and softening of the brain. Recently, many studies about the relationship between the genes of coagulation factors and acute cerebral infarction (ACI) have been made. Thrombomodulin (TM) as a thrombin receptor plays an important role in the balance of coagulation fibrinolytic system.Its gene mutation and plasma levels in patients may be related with atherosclerosis, cerebral infarction and other diseases.But few researches about the TM gene G127A Mutation and ACI have been published. To investigate whether TM gene G127A polymorphism and TM plasma concentration are associated with cerebral infarction, we conducted a a case-control study.[Methods] 80 acute Chinese han cerebral infarction cases and 80 controls admitted to the department of neurology at the first people's hospital of Yunnan province between November 1,2009 and June 30,2010 were studied. The time between ischemic event and hospitalization is less than 7 days.Controls without cerebral infarction were recruited among individuals hospitalized at the same time, who were matched to cerebral infarction patients by sex, age and complications.The mutation of thrombomodulin G127A were identified by DNA extraction, polymerase chain reaction and restriction fragment length polymorphism (RFLP). The thrombomodulin serum levels were detected by enzyme-linked immunosorbent assay (ELISA).[Results]1.The rate of smoking and alcohol, the level of triglyceride, APTT and PT were no significant differences in the two groups (P> 0.05), whereas the levels of total cholesterol, HDL-C, LDL-C, TM, GLU, hypertension, PLT, TT, FIB and carotid artery intima-media thickness were different(P<0.05).2. The plasma TM level in 80 cases of acute cerebral infarction were 5.01±2.47 pg/mL, which was higher than that of the control group(2.93±0.73 pg/mL)(P<0.05).3. The plasma levels of TM, blood glucose and fibrinogen showed a correlation with carotid artery intima-media thickness by the multiple regression analysis.4. TM gene G127A mutation was not detected in two groups (P> 0.05).[Conclusions] 1. Hypertension, TM plasma levels, GLU, LDL-C, HDL-C are associated with acute cerebral infarction.The four factors in front can increase the relative risk of acute cerebral infarction, whereas HDL-C is a protective factor. 2.Thrombomodulin plasma levels were significantly higher in patients with ACI than that of control, and the change of TM plasma levels may play an improtant role in the pathogenesis of ACI.3. TM plasma levels, blood glucose and increased fibrinogen may cause arterial intimal thickness increased, thus increasing atherosclerosis severity, and promoting the occurrence and development of cerebral ischemia.4. In this study, the TM gene G127A mutation were not found in the two groups of Chinese Han people, it may not be an risk factor for acute cerebral infarction.