From the Guidelines
High levels of tissue factor result in increased blood clotting and thrombosis, leading to serious conditions such as deep vein thrombosis, pulmonary embolism, stroke, or myocardial infarction, with a significant correlation between high TF expression and poor prognosis in cancer patients, as seen in studies such as 1. Tissue factor is a protein that initiates the extrinsic pathway of blood coagulation when it comes into contact with blood, triggering a cascade that ultimately leads to fibrin formation and clot development. When tissue factor levels are elevated, this coagulation process becomes overactive, potentially causing dangerous blood clots in arteries and veins. Elevated tissue factor is associated with various pathological states including cancer, inflammation, sepsis, and atherosclerosis. In cancer patients, tumor cells often express high levels of tissue factor, contributing to the hypercoagulable state frequently observed in malignancy, with a study from 1 showing that high levels of TF expression were significantly more frequent among patients with venous thromboembolism (VTE) than among those with low levels. The relationship between tissue factor and thrombosis is particularly important in understanding why certain conditions increase clotting risk and in developing targeted anticoagulant therapies that might interfere with tissue factor activity, as highlighted in a more recent study 1 which emphasizes the importance of monitoring TF expression in therapeutics intended for intravascular delivery. Key points to consider include:
- Tissue factor expression is a major determinant of cell product hemocompatibility
- High variability in TF expression exists among different tissue sources, with potential lethal consequences for patients when infused systemically
- Routine monitoring of TF expression is crucial in therapeutics intended for intravascular delivery, as suggested by 1.
From the Research
High Levels of Tissue Factor
- High levels of tissue factor can lead to thrombosis, as it is a transmembrane glycoprotein that functions as the primary cellular initiator of blood coagulation 2
- Elevated levels of circulating tissue factor are associated with various diseases, such as sepsis and cancer, which can lead to thrombosis 2
- Tissue factor expression in vital organs, such as the heart and lung, may provide additional hemostatic protection from mechanical injury to blood vessels, but high levels can also contribute to thrombosis 2
- Inhibition of tissue factor activity may decrease thrombosis associated with a variety of diseases, particularly in patients with tissue factor expression in vascular cells and elevated levels of circulating tissue factor 2
Relationship to Venous Thromboembolism
- Venous thromboembolism (VTE) is a life-threatening cardiovascular disease that can be caused by high levels of tissue factor, among other factors 3, 4, 5
- Treatment of VTE typically involves anticoagulation therapy, which can help prevent recurrent VTE and reduce the risk of thrombosis 3, 4, 5, 6
- New oral anticoagulants, such as apixaban and rivaroxaban, have been shown to be effective in treating VTE and preventing recurrent VTE, with a lower risk of major bleeding compared to traditional therapy 5, 6