Primary Thrombophilia in México XI: Activated Protein C Resistance Phenotypes are Multifactorial

Abstract

Activated protein C resistance (aPCR) phenotypes represent around 20% of the laboratory findings in Mexican Mestizos having suffered thrombosis and displaying clinical markers of thrombophilia. In a single institution for a 276-month period, 96 Mexican mestizos with a history of thrombosis and clinical markers of a primary thrombophilic state were prospectively studied to identify a thrombophilic condition. An abnormal aPCR phenotype was identified in 18 individuals. Evaluation of those with an abnormal aPCR phenotype, identified that 44% had factor V Leiden mutation, 22% increased levels of factor VIII, 16% anti-phospholipid antibodies and 6% a lupus anticoagulant. In the remaining 22%, the use of direct oral anticoagulants (DOACs) in the past period of 12-24 h was recorded. We found significant associations between abnormal aPCR phenotype and the factor V Leiden mutation ( = 0022), between abnormal aPCR phenotype and the use of DOACs ( = 0.006) and between antiphospholipid antibodies and lupus anticoagulant ( < 0.0001). These data are consonant with those observed in other populations and further identify that consideration be given to identifying whether individuals are being treated with the novel DOACs when conducting laboratory studies oriented to identify the etiology of thrombosis.

The Effects of Plant-Derived Oleanolic Acid on Selected Parameters of Glucose Homeostasis in a Diet-Induced Pre-Diabetic Rat Model

“…In the present study, we observed that HFHC diet led to increased HbA1c indicating the moderate hyperglycaemia found in pre-diabetes [ 40 ]. However, the administration of OA decreased HbA1c and this may be due to OA sensitizing skeletal myocytes for insulin which led to translocation of GLUT 4 and subsequently the uptake of glucose by the cells [ 41 ]. Furthermore, these results suggest that OA started exerting these effects at the beginning of the study as HbA1c reflects average plasma glucose over the previous eight to 12 weeks [ 42 ].…”

Pharmacogenetics and Personalized Medicine in Hematology

“…Vallejo-Villalobos et al [11] found that activated protein C resistance (APCR) that remained unexplained in patients with thrombosis even after testing for factor V Leiden, increased factor VIII levels and anti-phospholipid antibodies, actually correlated with the intake of directacting oral anticoagulants in the last 12-24 h. Factitious over-estimation of APCR is a known interference of both direct thrombin and Xa inhibitors [12]. The importance of integrating clinical information in laboratory assay interpretation therefore cannot be overemphasized, even in this era of high-end genomics.…”