Review Article

Determination of ADAMTS13 and Its Clinical Significance for ADAMTS13 Supplementation Therapy to Improve the Survival of Patients with Decompensated Liver Cirrhosis

Figure 2

Platelet counts and plasma levels of ADAMTS13 : AC and its related parameters in patients with chronic liver diseases. Platelet counts decreased with the severity of chronic liver diseases, but no difference was found between Child B and C (a). Plasma ADAMTS13 : AC determined by ELISA progressively decreased with worsening cirrhosis (b). Arrows indicate patients whose plasma ADAMTS13 : AC was extremely low (< 3% of normal control by VWFM assay). The ADAMTS13 : AG levels determined by ELISA also decreased with increasing cirrhosis severity (c), which highly correlated with ADAMTS13 : AC measured by the act-ELISA ( , ). The VWF : Ag increased with the progression of chronic liver diseases, but the difference between Child B and C did not reach statistical significance (d). The VWF : RCo is higher in liver cirrhosis patients than that in patients with chronic hepatitis and healthy subjects, but it did not differ among subgroups within liver cirrhosis (e). The VWF : RCo relative to ADAMTS13 : AC progressively increased with worsening chronic liver disease (f). Open circles: normal controls; open triangles: chronic hepatitis; open squares: cirrhosis with Child A; closed triangles: cirrhosis with Child B; closed circles: cirrhosis with Child C. Shaded area shows normal range. ADAMTS13 : AC : ADAMTS13 activity, ADAMTS13 : AG = ADAMTS13 antigen. VWF : Ag = von Willebrand factor antigen, VWF : RCo = von Willebrand factor ristocetin cofactor activity; * , ** , and *** significantly different between the two groups. (Partially modified from Uemura et al., [30]).
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