Plasma fibrinopeptide A and betathromboglobulin as markers for thrombosis in clinical disease

Douglas, Jessie T (1983) Plasma fibrinopeptide A and betathromboglobulin as markers for thrombosis in clinical disease. PhD thesis, University of Glasgow.

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This thesis investigates the value of plasma fibrinopeptide A and beta-thromboglobulin as markers for thrombosis. The role played by intravascular fibrin deposition and platelets in thrombosis has recently aroused great interest as well as controversy. Recently developed tests measuring in vivo thrombin generation (fibrinopeptide A) and platelet release (beta-thromboglobulin) might therefore be of value as markers for thrombosis. Because of the highly specialised area of this research I was required by my supervisor to extensively review the different mechanisms which have been postulated as causes of thrombosis. In order to understand the problems surrounding these proposed mechanisms a detailed discussion on the biochemistry of the haemostatic mechanism is given in Chapter 1. The proposed mechanisms surrounding thrombosis are then discussed in detail in Chapter 2. The methods currently available for the measurement of platelet activation and release (beta-thromboglobulin) are discussed in Chapter 3. Intravascular fibrin deposition has recently been suggested to be the result of an imbalance in thrombin or plasmin generation as discussed in Chapter 2. Chapter 4 therefore discusses in detail the development of techniques for measuring fibrinopeptide A and the recently developed assay of plasmin activity BB 15-42, as well as their application to previous clinical studies. Details of the methods used for the studies to be described in this thesis are given in Chapter 5. The first clinical studies undertaken in this thesis examined plasma levels of BTG and FPA in patients with pre-eclampsia and pregnancy hypertension (Chapter 6). Measurements of plasma levels of BTG, FPA and BB 15-42 were studied in patients with venous thrombosis as described in Chapter 7. The last study in Chapter 7 measured plasma BTG levels in an older patient group, patients with malignancy and patients with non-vascular illnesses such as chest infection and compared these groups to a young control group. Plasma levels of BTG, FPA and BB 15-42 were subsequently measured in arterial thrombosis as described in Chapter 8. The next study in Chapter 8 found little evidence of increased plasma levels of BTG, FPA or BB 15-42 in patients with coronary disease and no relation between these parameters and the extent of the coronary artery disease. The following study found no evidence of platelet activation or fibrin formation in patients with type II or IV hyperlipoproteinaemia. The measurement of BTG and FPA as tests for in vitro blood compatibility of artificial surfaces are described in Chapter 9. BTG was found to be a marker of blood compatibility as observed by the finding that silicone was more thrombogenic than polypropylene, and polyvinyl chloride was more thrombogenic than silicone. As discussed in Chapter 10 the results obtained in this thesis have suggested that abnormalities are suggested but not necessarily proved to occur in both venous and arterial thrombosis. The measurement of BTG, FPA and BB 15-42 has provided some insight into the possible mechanisms of thrombosis and are useful tools in further clinical investigations. (Abstract shortened by ProQuest.).

Item Type: Thesis (PhD)
Qualification Level: Doctoral
Additional Information: Adviser: C D Forbes
Keywords: Medicine
Date of Award: 1983
Depositing User: Enlighten Team
Unique ID: glathesis:1983-73841
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 14 Jun 2019 08:56
Last Modified: 14 Jun 2019 08:56

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