The author of a report [39] adopted ROC curve analysis to assess diagnostic performance of these core proteins in 120 VTE patients. When a comparison was made between VTE patients and non-VTE patients plus healthy controls, the AUC of integrin β1, integrin β2 and integrin β3 was 0.870, 0.821 and 0.731, respectively. Optimum cutoffs of integrin β1, integrin β2 and integrin β3 calculated according to Youden's index were 10.29pg/ml,91.10pg/ml and 10.35pg/ml, respectively. With these optimum cutoffs, the sensitivity,specificity, positive predictive value and negative predictive value of integrin β1 were 80.3%, 83.7%, 71.1% and 89.3%, respectively; integrin β2 78.6%, 73.7%, 59.4% and 87.6%;integrin β3 68.4%,71.2%, 54.3% and 81.8%. The AUC of combined three integrins was 0.916, the sensitivity, specificity, positive predictive value and negative predictive value were 84.6%, 90.8%, 81.7% and 92.0%, respectively. Clinical researches have confirmed significantly increased expression of integrins β1, β2 and β3 in VTE patients, which had relatively high specificity and sensitivity.

Taken together, with underlying conditions of collapsed immune cell balancing function, cells infected by pathogenic microorganisms and malignant cells may trigger intravenous immune adhesive inflammation, which is the defensive reaction in human body to establish the intravenous biological filter preventing infected cells and malignant cells from flowing back. However, the red thrombus forms and the defense transfers into thrombotic disease, when the filter is filled with red blood cells.

People with collapsed immune cell balancing functions are the vulnerable groups for venous thromboembolism. In a patient of venous thromboembolism,it is very possible that the genesis of venous thrombosis was triggered by infected cells or malignant cells. Only under the condition of immune cell balancing function collapse, the risk factors, such as advanced age, infection, malignancy, autoimmune disease, pregnancy, long trip syndrome, as well as family history may cause venous thrombosis. However, even with definable risk factors, there is no risk of getting venous thromboembolism in patients without collapsed immune cell balancing function.

Core proteins in acute venous thrombus are integrins β1, β2 and β3. The increased integrin β1 is the characterized expression in people with risk factors of VTE. However this increased expression of integrins β1, β2 and β3 was not found in patients following trauma or surgery calling into question that such patients may have no VTE risk.Therefore, trauma or surgery may be not the “true” risk factor for VTE.

It should be extended to the upstream of the disease from the middle and lower reaches to prevent the VTE, to decrease the incidence and to increase the cure rate.Hence, it is not enough only to prevent and reduce the known risk factors. Rather, the adjustment and improvement of immune cell balancing function, lowering the stress level inside human body, and restoring the balance of neuroendocrine functions, are new contents of prevention, treatment and rehabilitation of VTE.

(Published: Int J Clin Exp Med 2015;8(11):19804-19814)