Parsons Martin Em, O'Connell Karen, Allen Seamus, Egan Karl, Szklanna Paulina B, McGuigan Christopher, Ní Áinle Fionnuala, Maguire Patricia B
University College Dublin, Ireland.
Mult Scler J Exp Transl Clin. 2017 Dec 26;3(4):2055217317747624. doi: 10.1177/2055217317747624. eCollection 2017 Oct-Dec.
Thrombin is well recognised for its role in the coagulation cascade but it also plays a role in inflammation, with enhanced thrombin generation observed in several inflammatory disorders. Although patients with multiple sclerosis (MS) have a higher incidence of thrombotic disease, thrombin generation has not been studied to date.
The aim of this study was to characterise calibrated automated thrombography parameters in patients with relapsing-remitting MS (RRMS) and primary progressive MS (PPMS) in comparison to healthy controls (HCs).
Calibrated automated thrombography was performed on platelet poor plasma from 15 patients with RRMS, 15 with PPMS and 19 HCs.
We found that patients with RRMS generate thrombin at a significantly faster rate than the less inflammatory subtype, PPMS or HCs. In addition, the speed of thrombin generation was significantly correlated with time from clinical diagnosis in both subtypes. However, in RRMS the rate of thrombin generation was increased with increased time from clinical diagnosis, while in PPMS the rate of thrombin generation decreased with increased time from clinical diagnosis.
These data likely reflect the differential active proinflammatory states in each MS subtype and provide novel mechanistic insights into the clinically relevant prothrombotic state observed in these patients.
凝血酶在凝血级联反应中的作用已得到充分认识，但其在炎症中也发挥作用，在几种炎症性疾病中观察到凝血酶生成增加。尽管多发性硬化症（MS）患者血栓性疾病的发病率较高，但迄今为止尚未对凝血酶生成进行研究。
本研究的目的是与健康对照（HC）相比，对复发缓解型MS（RRMS）和原发进展型MS（PPMS）患者的校准自动血栓形成参数进行特征描述。
对15例RRMS患者、15例PPMS患者和19例HC的乏血小板血浆进行校准自动血栓形成检测。
我们发现，RRMS患者产生凝血酶的速度明显快于炎症较轻的亚型PPMS或HC。此外，两种亚型中凝血酶生成速度均与临床诊断后的时间显著相关。然而，在RRMS中，凝血酶生成速率随临床诊断后时间的增加而升高，而在PPMS中，凝血酶生成速率随临床诊断后时间的增加而降低。
这些数据可能反映了每种MS亚型不同的促炎活性状态，并为这些患者中观察到的临床相关血栓前状态提供了新的机制见解。
