Recombinant human soluble thrombomodulin (rhTM) is a new anticoagulant agent that exerts anticoagulatory and anti-inflammatory effects and is effective in the treatment of disseminated intravascular coagulation (DIC). Disseminated intravascular coagulation (DIC) is a clinical entity characterized by the systemic activation of coagulation pathways that can result in organ failure via the generation of fibrin clots and may lead to clinical bleeding due to the consumption of platelets and coagulation factors. In patients with DIC, the disease progresses rapidly and the outcome is poor, with a 30â40% mortality rate due to the presence of severe underlying diseases such as infections, sepsis, malignancy, collagen disease, trauma and hematological disease . Therefore, anticoagulant therapies are expected to benefit the treatment of DIC. Recombinant human soluble thrombomodulin (rhTM) (RecomodurinÂ®, Asahi Kasei Pharma Corp., Tokyo, Japan) is a new anticoagulant agent that exerts anticoagulatory and anti-inflammatory effects via the activated protein C (APC) pathway. Thrombomodulin (TM) is a transmembrane protein on the endothelial cell surface that plays an important role in the regulation of intravascular coagulation. rhTM binds to thrombin to inactivate coagulation, and the thrombin-rhTM complex activates protein C to produce APC, which, in the presence of protein S, inactivates factors VIIIa and Va, thereby inhibiting further thrombin formation. Therefore, rhTM has been recently identified as efficacy on the treatment of DIC . The novel biological agent rhTM was approved and is being used clinically for DIC treatment in Japan. The effects of rhTM on DIC were previously examined in a multicenter, randomized clinical trial in Japan , and resolution of DIC was significantly better in the group treated with rhTM than in the group treated with unfractionated heparin. Therefore, the indications for rhTM administration to treat coagulation abnormalities have gradually expanded. Sugawara et al.  reported that 10 patients with severe postpartum hemorrhage with DIC were treated with rhTM, and rhTM reduced the coagulation abnormalities, including the D-Dimer levels. Therefore, rhTM may be effective adjunctive therapy in the management of DIC related to hemorrhage. Scholarly journals are generally academic journals that encourage academic and scientific research. These journals generally prefer to publish original works, conducted following a systematic research methodology. The articles published in the scholarly journals are critically evaluated following in-depth analysis of the research data. Scholarly Journal articles strictly adhere to a standard format of writing. Once the author accomplishes their task of writing following the standard format and submits the manuscript for publication, it is the responsibility of the scholarly journal to verify whether it is written as per the academic and research norms. Scholarly journals hence subject like medical and clinical articles for a blind peer review or double peer review system and expect the authors to correct and resubmit the research articles as per the expert opinion. Scholarly journals thus expect the authors to sign the declaration, stating that the work is original and unpublished that duly acknowledges the sources referred for information.
Last date updated on July, 2014