Coagulation activation in patients with an inflammatory syndrome

Boullanger, Nadine; Kouri, D. El; Trossaërt, Marc; Truchaud, F; Trewick, David; Planchon, B.

doi:10.1097/00001721-199803000-00007

Cited by 8 publications

(7 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…creased risk of thrombosis among HIV infected patients observed by Sullivan and associates (21). In case of inflammation, C4b-BP, as an acute phase reactant, increases (5,18). This can lead to a temporary reduction in free protein S antigen and protein S activity (5,10).…”

Section: Discussionmentioning

confidence: 91%

“…Boullanger and associates (18) however did not observe a decrease of free protein S in inflammatory syndromes other than HIV even though C4b-BP was increased. He demonstrated, that a higher level of C4b-binding protein did not reduce the level of free protein S. No deficiency for protein S and protein C was found in patients with inflammatory bowel disease (18,22), while even an increase of protein S and protein C activity in these patients has been observed (23). Therefore, un- specific inflammatory syndromes may not induce an acquired protein C and protein S deficiency, while protein S deficiency induced by HIV disease results in decreased free and total protein S antigen levels, but normal C4b-BP levels, suggesting that these changes may be different to those occuring in unspecific inflammation (9).…”

Section: Discussionmentioning

confidence: 97%

“…In case of inflammation, C4b-BP, as an acute phase reactant, increases (5,18). This can lead to a temporary reduction in free protein S antigen and protein S activity (5,10).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Acquired Protein C and Protein S Deficiency in HIV-Infected Patients

Erbe

Rickerts

Bauersachs³

et al. 2003

Clin Appl Thromb Hemost

View full text Add to dashboard Cite

Infection with human immunodeficiency virus (HIV) may lead to hemostatic imbalances. Forty-nine consecutive patients with acute opportunistic infections were screened for thrombophilic parameters. A follow-up investigation was performed after 10 +/- 8 weeks in 26 patients. In acutely ill patients, the incidence of protein S deficiency was 67% (33/49) and of protein C deficiency 25% (12/49), while at the follow-up visit the incidences were 54% (14/26) and 8% (2/26), respectively. Protein S and protein C levels increased significantly from initial to follow-up visit (p < 0.05). Lupus anticoagulants were not detected and anticardiolipin IgG antibodies were present in 11.4% (5/44). Three patients presented with deep venous thrombosis on admission; in two, protein S or protein C deficiency was observed. In conclusion, an acquired protein S and protein C deficiency often develop in patients with HIV and acute illness; this may be reversible after treatment for opportunistic infections.

show abstract

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Acquired Protein C and Protein S Deficiency in HIV-Infected Patients

Erbe

Rickerts

Bauersachs³

et al. 2003

Clin Appl Thromb Hemost

View full text Add to dashboard Cite

show abstract

“…However, when they occur together, persistent activation plays an important role in the preclinical phase of cancer, increasing the probability of an established malignancy (thereby raising incidence), proliferation and metastasis (thereby shortening the patients' survival time), especially in cancers of the digestive tract. Increased levels of soluble tissue factor, activated FVII, FXIIa, F1+2, FPA and fibrinogen turnover have been reported in the clinical phase of malignant disease [30–32].…”

Section: Discussionmentioning

confidence: 99%

Increased incidence of neoplasia of the digestive tract in men with persistent activation of the coagulant pathway

Miller

Bauer

Howarth

et al. 2004

Journal of Thrombosis and Haemostasis

View full text Add to dashboard Cite

Summary. Background: Thrombin promotes angiogenesis and cell proliferation in cancer. Whether thrombin turnover influences cancer incidence is unknown. Objectives: To explore the relation between the status of the coagulant pathway and cancer incidence by population survey. Methods: Of 4009 middle-aged men clinically free of malignancy, 3052 (76.1%) were recruited. Measurements of hemostatic status were made annually for 4 years, and follow-up for morbidity and mortality was maintained thereafter. Persistent activation of the coagulant pathway was diagnosed when prothrombin fragment 1+2 and fibrinopeptide A concentrations exceeded the upper quartiles of the population distribution in two consecutive annual examinations. Cancer incidence rates in men developing persistent activation (taking the time of onset of activation as baseline) were compared with those in men remaining free of this condition. Results: Persistent activation of the hemostatic pathway was a distinct entity found in 111 men [43 expected by chance alone (P < 0.001)], and associated with activation throughout the coagulation pathway. Total mortality (/1000 person-years) was higher in those with persistent activation than in others (17.1 and 9.7, respectively, P ¼ 0.015), owing to a higher mortality from all cancers (11.3 and 5.1, respectively, P ¼ 0.01), due in turn largely to a higher mortality from cancers of the digestive tract (6.3 and 1.9, respectively, P ¼ 0.004). Trends were similar for non-fatal cancers. Conclusions: Persistent activation of the coagulant pathway plays a role in the preclinical phase of cancer and is associated with an increased incidence of clinical malignancy, especially of the digestive tract.

show abstract

“…C4BP, which binds protein S, is a marker for acute inflammation. Even though we might expect that in inflammatory states, as the ones seen in COVID-19 patients, free protein S and protein S activity to be low, due to the high levels of C4BP, previous studies have shown that C4BP levels are not correlated with free protein S levels [17,18]. Protein S deficiency has also been linked to the presence of antiphospholipid antibodies [18,19,20], but these results are debatable, since others failed to show such an association [21].…”

Section: Variables and Statistical Analysismentioning

confidence: 99%

Anticoagulant protein S in COVID-19: low activity, and associated with outcome

Stoichitoiu

Pinte

Balea

et al. 2020

Romanian Journal of Internal Medicine

View full text Add to dashboard Cite

Introduction: COVID-19 disease was associated with both thrombo-embolic events and in-situ thrombi formation in small vessels. Antiphospholipidic antibodies were found in some studies.Aim: Assessment of protein S activity in patients with COVID-19 as a cause this prothrombotic state, and of the association of protein S activity with worse outcome.Methods: All patients admitted for COVID-19 disease in a university hospital between 15th of May and 15th of July 2020 were prospectively enrolled into this cohort study. Patients treated with antivitamin K anticoagulants and with liver disease were excluded. All patients had protein S activity determined at admission. The main outcome was survival, secondary outcomes were clinical severity and lung damage.Results: 91 patients were included, of which 21 (23.3%) died. Protein S activity was decreased in 65% of the patients. Death was associated with lower activity of protein S (median 42% vs. 58%, p<0.001), and the association remained after adjustment for age, inflammation markers and ALAT. There was a dose-response relationship between protein S activity and clinical severity (Kendall_tau coefficient = -0.320, p < 0.001; Jonckheere-Terpstra for trend: p<0.001) or pulmonary damage on CT scan (Kendall_tau coefficient = -0.290, p<0.001; Jonckheere-Terpstra for trend: p<0.001). High neutrophil count was also independently associated with death (p=0.002).Conclusion: Protein S activity was lower in COVID-19 patients, and its level was associated with survival and disease severity, suggesting that it may have a role in the thrombotic manifestations of the disease.

show abstract

Coagulation activation in patients with an inflammatory syndrome

Cited by 8 publications

References 0 publications

Acquired Protein C and Protein S Deficiency in HIV-Infected Patients

Acquired Protein C and Protein S Deficiency in HIV-Infected Patients

Increased incidence of neoplasia of the digestive tract in men with persistent activation of the coagulant pathway

Anticoagulant protein S in COVID-19: low activity, and associated with outcome

Contact Info

Product

Resources

About