thrombomodulin
THBDproteinThrombomodulin shedding from damaged endothelium impairs anticoagulation and indicates endothelial erosion/dysfunction in acute coronary events.
Pathway placement
Cascade stepEndothelial activation & erosion
Confidencehigh
RationaleEndothelial anticoagulant marker; soluble thrombomodulin reflects endothelial damage in MI.
Also acts inCoagulation / thrombus
Druggability
DruggableYes
Known drugs / candidates0
Small-molecule tractableYes
Antibody tractableYes
EnsemblENSG00000178726
Type I vs Type II discrimination
ScoresIndeterminate
R — rupture / Type-I33
C — confounder / Type-II44
A — assay feasibility68
E — evidence strength52
T1DI (composite)16
Specificity differential (R−C)-11
Confounder panel (Type-II drivers)
1sepsis / systemic inflammationmag 2
2anemia / acute blood lossn/a
3hypovolemia / dehydrationn/a
4tachyarrhythmian/a
5hypoxemia / respiratory failuremag 1
6hypertensive emergencyn/a
7high-demand / peri-operative stressmag 1
Coverage: 3/7 confounders with evidence
Tier: deep-scored (abstract-extracted) · 4 supporting references. See the discrimination table for all markers.
Assay & specimen
Class-level default (no specific cleared assay)— generic method inferred from analyte class; confirm against a specific product insert before use.
Specimen
Serum or plasma
Collection tube
Serum separator (gold/red-top, SST) · K2/K3-EDTA (lavender-top)
Method / principle
Sandwich immunoassay (ELISA) — research-grade unless a cleared assay exists
Reagent / substrate
Matched anti-target antibody pair (capture + labeled detection)
Platform
ELISA microplate or multiplex (Luminex/MSD)
Turnaround · availability
Send-out / research · Research-grade (no universal clinical assay)
Literature evidence(23)
- [Predictive value of four items of new thrombus markers combined with conventional coagulation tests for thrombosis in antiphospholipid syndrome].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2023 · PMID 38101785 · doi
- The Effect of Protease-Activated Receptor-1 (PAR-1) Inhibition on Endothelial-Related Biomarkers in Patients with Coronary Artery Disease.Thrombosis and haemostasis · 2022 · PMID 36588289 · doi
- Prognostic importance of biomarkers associated with haemostatic, vascular and endothelial disturbances in acute coronary syndrome patients in relation to kidney function.International journal of cardiology · 2022 · PMID 36476672 · doi
- Persistent long-term platelet activation and endothelial perturbation in women with Takotsubo syndrome.Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie · 2021 · PMID 33450492 · doi
- Thromboinflammation Supports Complement Activation in Cancer Patients With COVID-19.Frontiers in immunology · 2021 · PMID 34491250 · doi
- Soluble thrombomodulin ameliorates aberrant hemostasis after rewarming in a rat accidental hypothermia model.Biochemical and biophysical research communications · 2021 · PMID 34856423 · doi
- Targeted gene expression analysis of human deep veins.Journal of vascular surgery. Venous and lymphatic disorders · 2020 · PMID 32860957 · doi
- miR-499 released during myocardial infarction causes endothelial injury by targeting α7-nAchR.Journal of cellular and molecular medicine · 2019 · PMID 31270949 · doi
- Thrombomodulin can predict the incidence of second events in patients with acute coronary syndrome: Single-center, retrospective cohort study.Journal of cardiology · 2018 · PMID 29887328 · doi
- Endothelial markers are associated with thrombolysis resistance in acute stroke patients.European journal of neurology · 2014 · PMID 24495004 · doi
- Acute myocardial infarction is associated with endothelial glycocalyx and cell damage and a parallel increase in circulating catecholamines.Critical care (London, England) · 2013 · PMID 23433357 · doi
- Tobacco smoke exposure and endothelial dysfunction in patients with advanced coronary artery disease.Polskie Archiwum Medycyny Wewnetrznej · 2013 · PMID 23827987 · doi
- Impaired anti-platelet effect of aspirin, inflammation and platelet turnover in cardiac surgery.Interactive cardiovascular and thoracic surgery · 2010 · PMID 20233808 · doi
- Circulating endothelial cells in coronary artery disease.Kardiologia polska · 2010 · PMID 20967702
- Platelet turnover, coagulation factors, and soluble markers of platelet and endothelial activation in essential thrombocythemia: relationship with thrombosis occurrence and JAK2 V617F allele burden.American journal of hematology · 2009 · PMID 19105233 · doi
- Endothelial function and markers of endothelial activation in relation to cardiovascular disease in systemic lupus erythematosus.Scandinavian journal of rheumatology · 2008 · PMID 18666029 · doi
- Endothelial activation, dysfunction, and damage in congestive heart failure and the relation to brain natriuretic peptide and outcomes.The American journal of cardiology · 2006 · PMID 16490435 · doi
- Circulating endothelial cells in atrial fibrillation with and without acute cardiovascular disease.Thrombosis and haemostasis · 2005 · PMID 16270620 · doi
- Endothelial cell markers and the risk of coronary heart disease: the Prospective Epidemiological Study of Myocardial Infarction (PRIME) study.Circulation · 2004 · PMID 15023872 · doi
- Down-regulation of endothelial expression of endothelial cell protein C receptor and thrombomodulin in coronary atherosclerosis.The American journal of pathology · 2001 · PMID 11549570 · doi
- A pilot study of streptokinase-induced endothelial injury and platelet activation following acute myocardial infarction.Journal of internal medicine · 2000 · PMID 11086642 · doi
- Circulating von Willebrand factor antigen II in atherosclerosis: a comparison with von Willebrand factor and soluble thrombomodulin.Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis · 1998 · PMID 9663709 · doi
- Useful laboratory tests for studying thrombogenesis in acute cardiac syndromes.Clinical chemistry · 1998 · PMID 9702994