P-selectin is a leukocyte receptor and platelet activation marker that has been shown to be involved in thrombogenesis as well as
bleeding disorders and may represent a possible link between
inflammation and
thrombosis. In animal models, high plasma levels correlated with a procoagulant tendency. In acute liver damage models such as hepatic ischaemia-
reperfusion-injury,
P-selectin was found to be a key mediator of liver injury. In order to investigate the clinical and pathogenetic role of
P-selectin in chronic
liver diseases, plasma
P-selectin levels were measured in 111 patients with chronic
liver diseases.
P-Selectin was significantly elevated in patients (median 56 ng/ml, range 0-180) compared with controls (n = 38, median 20 ng/ml, range 3.3-42, P < 0.001). Current clinical
bleeding symptoms were common, whereas thrombotic events occurred rarely.
P-selectin levels were not associated with haemorrhagic or thromboembolic complications.
P-selectin correlated with platelet and white-blood-cell counts, but not with endothelial injury markers
thrombomodulin and
tissue factor or
coagulation factors. Interestingly,
P-selectin levels were not associated with Child's stage of
cirrhosis or disease aetiology, but were generally elevated in chronic
liver diseases. Severe hepatic leukocyte infiltration in liver histology was associated with a tendency towards higher
P-selectin levels. In line with its role in acute liver damage,
P-selectin elevation in chronic
liver disease may suggest a possible pathogenetic role in the course of
liver cirrhosis.