THBD and endothelial dysfunction: sEPCR was shown to be a very sensitive marker of endothelial dysfunction and coagulation: for example, sEPCR levels were increased in sepsis and lupus erythematosus, two conditions known to be associated with inflammation and coagulation, more than soluble thrombomodulin, an established marker of endothelial damage that belongs to the same anticoagulant pathway as EPCR [10].