Thrombomodulin: tumour biology and prognostic implications

Background. Thrombomodulin (TM) is an endothelial. receptor that exerts anti-coagulant, anti-fibrinolytic, and anti-inflammatory activity by inhibiting thrombin and cellular adhesion. There is growing evidence that TM plays a rote in tumour behaviour. Methods. The electronic literature (1966-2004) was reviewed with a specific focus on tumour biology. Results. TM is expressed on both the endothelium and tumour cells in several cancers. Loss of expression denotes a more malignant profile with poorer prognosis. Loss of TM is mediated by hypoxia, endotoxin, and various cytokines, while upregulation can be achieved by pharmacological manipulation (e.g. pentoxyfylline and statins). Conclusion. Originally described as an endothelial anticoagulant, TM plays a key rote in tumour biology and prognostics, and provides a potential therapeutic target in impeding cancer spread. (c) 2004 Elsevier Ltd. All rights reserved.