Details

Autor(en) / Beteiligte

• Mehic, Dino
• Schramm, Theresa
• Forstner-Bergauer, Birgit
• Haslacher, Helmuth
• Ay, Cihan
• Pabinger, Ingrid
• Gebhart, Johanna

Titel

Activated protein C and free protein S in patients with mild to moderate bleeding disorders

Ist Teil von

• Thrombosis research, 2024-03, Vol.235, p.98-106

Ort / Verlag

United States: Elsevier Ltd

Erscheinungsjahr

2024

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Underlying mechanisms for bleeding and impaired thrombin generation (TG) and plasma clot formation (PCF) in patients with mild to moderate bleeding disorders (MBDs) are still to be elucidated, especially in bleeding disorder of unknown cause (BDUC). The role of the natural anticoagulants activated protein C (APC) and free protein S (PS) has not yet been investigated in this patient population. To analyze antigen levels of APC and PS in patients with MBDs and BDUC and investigate associations to clinical bleeding phenotype and severity as well as and hemostatic capacity. Antigen levels of APC and free PS were measured in 262 patients from the Vienna Bleeding Biobank (VIBB), a single-center cohort study, by ELISA and compared to 61 healthy controls (HC). Antigen levels of APC were higher in MBD patients than in HC when adjusted for age, sex and BMI (median (IQR) 33.1 (20.6–52.6) and 28.6 (16.4–47.2) ng/mL). This was most pronounced in patients with BDUC (35.3 (21.7–54.3) ng/mL). No differences in PS antigen levels between patients and HC were seen overall, or according to specific diagnoses. Further, no association between APC or PS and bleeding severity or global tests of hemostasis or TG were identified, while paradoxically APC weakly correlated with shorter lag time and time to peak of PCF in BDUC. Our data demonstrate increased antigen levels of APC in BDUC, which might contribute to the bleeding tendency in some patients and could be a future therapeutic target in BDUC. [Display omitted] •Influence of APC and protein S on hemostatic capacity in BDUC patients is unclear.•APC antigen levels were higher in BDUC patients than in healthy controls.•No association between APC/protein S and bleeding severity was identified.•APC might contribute to hemostatic impairment and could be a therapeutic target.