THBD and systemic inflammatory response syndrome: Another study with sepsis and SIRS patients focusing on the link between endothelial-derived EVs and DIC discovered a negative correlation between the ratio of thrombomodulin (TM)- and TF-positive EVs from endothelial cells with DIC scores, suggesting that anticoagulant activity of TM-positive endothelial EVs decreases while procoagulant activity of TF-positive endothelial EVs increases during DIC progression [45].