OBJECTIVES: Hypofibrinolysis has been proposed as a possible mechanism underlying the known risk of thrombosis observed in patients with inflammatory bowel diseases (IBD). Thrombin-activatable fibrinolysis inhibitor (TAFI) is a recently described inhibitor of fibrinolysis. Increased TAR plasma levels are associated with a risk for venous thrombosis. The objective was to evaluate TAR plasma levels and their possible correlations with clinical features and acute-phase reactants in IBD patients. METHODS: Eighty-one IBD patients (47 Crohn's disease and 34 ulcerative colitis) and 81 sex- and age-matched healthy controls were enrolled in the study; moreover, we studied 30 inflammatory controls (13 Reiter's syndrome, 4 Behget's syndrome, and 13 patients with newly diagnosed celiac disease). TAR plasma levels were assessed by means of a commercially available ELISA kit. Erythrocytes sedimentation rate, C-reactive protein, and alpha1-acid glycoprotein were measured as acute-phase reactants. Statistical analysis was performed by means of nonparametric tests and Fisher's exact test and chi(2) test for independence. RESULTS: Median TAR plasma levels were significantly higher in IBD patients (116.0%, range: 39.0-232.0%) and in inflammatory controls (176.0%, 50.0-435.0%) than in healthy controls (99.0%, 40.0-170.0%) (p < 0.05 and p < 0.001, respectively). TAR plasma levels higher than the 95th percentile of control values were significantly more frequent in IBD patients (19.7%) and in inflammatory controls (53.3%) than in healthy controls (4.9%) (p < 0.008 and p < 0.0001, respectively) and more frequent in clinically active IBD than in clinically quiescent IBD (31.4% vs 10.9%, p < 0.03). Finally, in IBD, significant correlations were observed between TAR plasma levels and erythrocytes sedimentation rate (p < 0.02), C-reactive protein (p < 0.001), and a1-acid glycoprotein (p < 0.05). CONCLUSIONS: TAR plasma levels are increased in IBD patients and correlate with acute-phase reactants. Increased TAR plasma levels might contribute to the prothrombotic state observed in IBD through the induction of hypofibrinolysis.
Assessment of thrombin-activatable fibrinolysis inhibitor (TAFI) plasma levels in inflammatory bowel diseases
Danese S;
2004-01-01
Abstract
OBJECTIVES: Hypofibrinolysis has been proposed as a possible mechanism underlying the known risk of thrombosis observed in patients with inflammatory bowel diseases (IBD). Thrombin-activatable fibrinolysis inhibitor (TAFI) is a recently described inhibitor of fibrinolysis. Increased TAR plasma levels are associated with a risk for venous thrombosis. The objective was to evaluate TAR plasma levels and their possible correlations with clinical features and acute-phase reactants in IBD patients. METHODS: Eighty-one IBD patients (47 Crohn's disease and 34 ulcerative colitis) and 81 sex- and age-matched healthy controls were enrolled in the study; moreover, we studied 30 inflammatory controls (13 Reiter's syndrome, 4 Behget's syndrome, and 13 patients with newly diagnosed celiac disease). TAR plasma levels were assessed by means of a commercially available ELISA kit. Erythrocytes sedimentation rate, C-reactive protein, and alpha1-acid glycoprotein were measured as acute-phase reactants. Statistical analysis was performed by means of nonparametric tests and Fisher's exact test and chi(2) test for independence. RESULTS: Median TAR plasma levels were significantly higher in IBD patients (116.0%, range: 39.0-232.0%) and in inflammatory controls (176.0%, 50.0-435.0%) than in healthy controls (99.0%, 40.0-170.0%) (p < 0.05 and p < 0.001, respectively). TAR plasma levels higher than the 95th percentile of control values were significantly more frequent in IBD patients (19.7%) and in inflammatory controls (53.3%) than in healthy controls (4.9%) (p < 0.008 and p < 0.0001, respectively) and more frequent in clinically active IBD than in clinically quiescent IBD (31.4% vs 10.9%, p < 0.03). Finally, in IBD, significant correlations were observed between TAR plasma levels and erythrocytes sedimentation rate (p < 0.02), C-reactive protein (p < 0.001), and a1-acid glycoprotein (p < 0.05). CONCLUSIONS: TAR plasma levels are increased in IBD patients and correlate with acute-phase reactants. Increased TAR plasma levels might contribute to the prothrombotic state observed in IBD through the induction of hypofibrinolysis.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
